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Biomedical subjects

S Maeda

Publications and source records attributed to S Maeda.

At least 631 records · Page 35Linked to original sources
PubMed1991

[Systolic anterior motion of the anterior mitral leaflet and/or the chordae tendinae in the elderly].

Systolic anterior motion of the anterior mitral leaflet and asymmetric septal hypertrophy (ASH) are characteristic features of hypertrophic obstructive cardiomyopathy (HOCM) on an echocardiogram. Among 9,670 patients over 60 years old examined by echocardiography from January, 1984 to October, 1990, 55 patients showed systolic anterior motion of the anterior mitral leaflet and/or the chordae tendinae (SAM). We investigated clinical features and morphological features of the left ventricle on an echocardiogram in the 55 patients with SAM. They were classified into three groups according to the degree of SAM. Thirty eight cases (group I) had no mitral and/or chordal-septal contact, 10 (group II) had brief contact (less than 30% on the echocardiographic systole) and 7 (group III) had prolonged contact (greater than or equal to 30%). Ages ranged from 60 to 99 with a mean age of 78.2 years. There were 19 males and 36 females and there was a predominance of females in each group. Thirty five cases had hypertension and 34 left ventricular hypertrophy on electrocardiograms. One case of group I, 3 of group II and 7 of group III had a clinical diagnosis of HOCM. In comparison with each group, the incidence of LVH (SV1 + RV5 greater than or equal to 35 mm) was 52% in group I, 90% in group II and 83% in group III and that of LVH (SV1 + RV5 greater than or equal to 70 mm) was 29%, 20% and 67%, respectively. On echocardiographic examination, the diastolic descent rate of the anterior mitral leaflet in the 3 groups was 36.1 +/- 13.1 mm/sec, 19.4 +/- 13.1 mm/sec and 10.7 +/- 11.8 mm/sec (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1991

[Reconstruction of hypopharynx and cervical esophagus using a free jejunal graft].

Forty-four patients with cancer in the hypopharynx and cervical esophagus underwent pharyngoesophageal reconstruction with a free jejunal graft after total removal of a tumor combined with resection of the circumferential tissues. The graft survival rate was 93.2% (41 of 44). Postoperative complications occurred in 16 patients (36.4%), which included postoperative death in one (2.3%), graft necrosis in 3 (6.8%), fistula formation in 4 (9.1%) and graft stricture in 3 (6.8%). All 3 cases of graft necrosis underwent successfully reimplantation. The mean interval time was 20.9 days until oral intake was possible. Thirty-two of 42 patients (76.2%) were able to take usual food. Esophageal speech was limited in the selected cases by this procedure. A cumulative survival rate of 5 years was 40.6% in this series. This method of reconstruction should be advocated as one of relatively safe and reliable procedures for patients with hypopharyngeal and cervical esophageal cancer.

Adult↗
PubMed1991

[Immunohistochemical study of parathyroid hormone related protein (PTHrP) in renal cell carcinoma].

Parathyroid hormone related protein (PTHrP) is the main factor of humoral hypercalcemia of malignancy (HHM). Using anti-PTHrP monoclonal antibody 4B3, we investigated the immunohistochemical localization of PTHrP in human normal renal tissues and renal cell carcinomas. Among normal renal tissues, distal tubules and collecting ducts showed positive immunostaining. Among 36 cases of renal cell carcinoma, PTHrP was detected in 30 cases (83%), and there was no significant correlation between the degree of the immunostaining and the serum calcium levels of the patients. As for the histopathological types of the renal cell carcinomas, granular cell subtypes tended to be more strongly positive than clear cell ones. In conclusion, it was not uncommon that PTHrP was commonly presented by renal cell carcinoma, and HHM occurred when the PTHrP transgressed the homeostatic mechanisms.

Adult↗
PubMed1991

[Endourological re-establishment by transluminal puncture for a complete obliteration of traumatic urethral disruption].

We performed transluminal re-canalization by needle puncture under fluoro-endoscopic control on a total of ten patients (membranous urethra, 8; bulbous urethra, 2) with complete obliteration after traumatic urethral disruption. The re-canalized tract was created by balloon dilation, internal urethrotomy or endoscopic resection of the scar tissue. The patient age ranged from 10 to 57 years (mean age; 37.9 +/- 15.3 years). A transluminal puncture was attempted in three patients by transperineal-transurethral approach and in seven by transurethral approach. In one of them, who sustained a complete membranous disruption 5 weeks ago, transluminal puncture failed because of the movable proximal urethra. The remaining nine patients voided without difficulty for the mean follow-up period of 18.1 +/- 14.3 months (range: 2-46). Three patients had mild stress urinary incontinence. A transluminal puncture is less invasive, safe and reliable for re-establishment of the true proximal part of the disrupted urethra. It can be recommended as a useful technique for endo-urological re-establishment for a completely obliterated urethra. Although this endoscopic re-establishment requires urethral sounding or internal urethrotomy for 6 months postoperatively, it may be an alternative to conventional surgical repair.

Adolescent↗
PubMed1991

Hepatopancreatoduodenectomy for advanced carcinoma of the biliary tract.

Twenty-four patients with advanced carcinoma of the gallbladder and/or the bile duct underwent hepatopancreatoduodenectomy, that is, en bloc hepatic resection with pancreatoduodenectomy. They included 14 cases of gallbladder carcinoma, nine cases of bile duct carcinoma, and one case of double cancer of the gallbladder and the bile duct. Eleven kinds of hepatic lobectomy or segmentectomy with pancreatoduodenectomy were carried out, and the caudate lobe was also removed en bloc from 17 patients with carcinoma involving the hepatic hilus. Combined resection of the portal vein was performed in 11 patients, of the inferior vena cava in 2, and of the colon in 5, patients. Forty-four postoperative complications occurred in 22 patients (91.7%). The operative mortality rate was 12.5% (3/24). The median survival and the 2-year survival rate were 7.0 months and 17.9% for all 24 patients, including 3 operative deaths, or 11.0 months and 20.4% for 21 patients surviving hepatopancreatoduodenectomy, and 12.4 months and 20.8% for all 14 patients with gallbladder carcinoma, and 5.2 months and 14.8% for all 9 patients with bile duct carcinoma. The longest survivor died of recurrent tumors at 5 years and 7 months. Hepatopancreatoduodenectomy offered not only an unexpectedly long survival period, but also unexpected morbidity in some cases.

Adenoma, Bile Duct↗
PubMed1991

[A case of presumed radiation optic neuropathy].

A case of a 37-year-old woman with radiation optic neuropathy was reported. She had undergone subtotal removal of the right orbital tumor (adenoid cystic carcinoma) by frontal craniotomy, followed by radiation therapy (64Gy). She had been quite well until she noticed a gradual loss of vision in her right eye 18 months later. Her visual acuity was 0.2 in the right eye and 1.5 in the left eye with right relative afferent pupillary defect and dense central scotoma. Funduscopy revealed optic disc swelling with surrounding retinal edema and small hemorrhage in the right eye. Fluorescein angiography revealed a hypoperfusion area and obstruction of the small retinal vessels in the posterior pole, but this was not large enough to explain the dense central scotoma. Although prednisolone therapy gave temporary improvement, the visual function gradually deteriorated.

Adult↗
PubMed1991

Spontaneous isolated intra-abdominal mesenteric fibromatosis. Case report.

Magnetic resonance imaging in a 54-year-old Japanese man showed a huge low-intensity abdominal mass on T1 WI and a high-intensity tumoral structure with low-intensity bundles on T2 WI. The histologic diagnosis was intra-abdominal mesenteric fibromatosis. As the levels of tissue estrogen and progesterone receptors were not elevated (both less than 5 FMOL/mg), tamoxifen treatment was not indicated.

Fibroma↗
PubMed1991

A transgenic mouse line developed to express human amyloidogenic transthyretin cDNA in the brain.

To elucidate the role of amyloid deposits in the pathogenesis of degenerative disorders of brain, we attempted to develop transgenic mice producing amyloidogenic human variant transthyretin (TTR) in the brain. A minigene, in which the promoter region of the mouse myelin basic protein (MBP) gene was ligated to the human mutant TTR cDNA, was used for microinjection. A transgenic mouse line expressing the human TTR mRNA specifically in the brain was thus derived. However, human TTR was not detected in the brain or in the serum of these mice. These data suggest that the human mutant TTR mRNA is not efficiently translated in the mouse brain.

Amino Acid Sequence↗
PubMed1991

[11 cases of anaphylaxis caused by grand keyhole limpet (abalone like shellfish)].

We reported 11 cases of patients who developed moderate to severe anaphylactic reactions induced by the ingestion of grand keyhole limpet (GKL) and abalone. Specific IgE-mediated hypersensitivity to these shellfish was demonstrated by history, skin prick test, RAST and immunoblotting. The RAST inhibition technique revealed cross antigenicity between GKL, abalone and keyhole limpet hemocyanin. By immunoblotting analysis, the major antigens of GKL are shown in the MW range of about 38 Kd and 80 Kd.

Adolescent↗
PubMed1991

Autopsy rates in medical schools and hospitals in Japan.

The autopsy rates in Japanese medical schools and hospitals were reviewed. Although moderate autopsy levels have been maintained in medical schools (50%) and large training hospitals (30%), a slight tendency towards a decrease was demonstrated recently. Since autopsy is important in education, research and the quality control of medicine, it is essential to keep the autopsy rate high. Our analyses indicate that autopsy gives satisfaction to clinicians if clinical data are correlated in detail with pathological findings. Thus, efforts should be directed to strengthening the training of pathologists in the analysis of clinical data, which are essential for correct pathological diagnoses. In order to cope with the rapid progress in all fields of medicine, pathologists must collaborate with clinical staff to obtain all the information necessary for interpretation of autopsy data. This action also helps to keep the autopsy rate high. No international guidelines are available on autopsy. Autopsies are carried out for different purposes at different levels. An internationally agreed set of rules would allow efficient use of autopsy data for epidemiological studies. Genetic analysis of autopsy material is now feasible, and this may be useful in tracing etiological factors, such as infections and genetic predisposition. Various aspects of autopsy must be reconsidered in the light of modern science.

Autopsy↗
PubMed1991

[Management of cholangitis complicated in biliary carcinoma with hilar bile duct stenosis].

We reviewed 60 cases of biliary carcinoma with hilar bile duct stenosis which had received percutaneous transhepatic cholangio-drainage (PTCD). Of the 60 cases, nine were complicated with acute cholangitis (AC) and three with segmental acute obstructive suppurative cholangitis (S-AOSC). The incidence of cholangitis was 20%. Six patients with AC and three with S-AOSC underwent hepatic resection for carcinoma. As to preoperative management for cholangitis in these 9 cases, conservative chemotherapy was effective in only 2 cases, and additional PTCD or segmental introduction of the drainage catheter under PTCS were useful in 5 cases. The remaining 2 cases with S-AOSC needed urgent hepatic resection including suppurative hepatic segments after various interventional treatments. No significant difference was found in resectability, morbidity and mortality between the cholangitis group and non-cholangitis group. In conclusion, it is emphasized that postoperative outcome of biliary carcinoma with cholangitis will be improved by adequate PTCD and/or urgent hepatic resection.

Acute Disease↗
PubMed1991

[Seven cases of eye involvement in adult with acute leukemia].

Seven acute leukemia cases with oculomotor paralysis and/or optic nerve paralysis were reported. Five cases were lymphoblastic and two were myelogenous leukemia. The average age was 30.7 years old and male to female ratio was 5:2. The eye involvement developed during hematological complete remission stage in 4 cases, and during relapsing stage in 2 cases. For the remaining case, eye symptom was an initial symptom of the disease. The computed tomography of ocular region showed tumorous involvement in 3 cases and no abnormality in other 4 cases. The white blood cell count on admission was over 30,000/microliters and leukemic cells occupied over 59% of bone marrow nucleated cells in 5 cases. Intrathecal administration, a whole brain irradiation and intra-arterial injection of Nimustin as well as standard systemic chemotherapy were performed against oculomotor and optic nerve involvement. Leucoencephalopathy occurred in 2 of 7 cases after intrathecal administration and irradiation. Since 1980, continuous treatment for prophylaxis of central nervous system leukemia have been done and this protocol was effective for meningeal involvement but not for ocular involvement.

Acute Disease↗
PubMed1991

[A case report of esophageal liposarcoma].

We report the first case of esophageal liposarcoma in Japan. A 46-year-old female was admitted to our hospital with chief complaint of protruding tumor out of the mouth. She had two episodes of protruding tumor after nausea in last 6 months. Barium swallow showed a large polypoid lesion of approximately 16cm in length with a stalk. By endoscopic examination, it was the polyp originated from the anterior wall of the cervical esophagus. It was covered with intact squamous epithelia, which had slight redness and erosion in the apex. Under general anesthesia the tumor was cut off at the base through the oral cavity. Specimen was 11 x 4 x 3cm in size and had yellowish cut surface. Histologically, the tumor composed of mature adipocytes and many atypical lipoblasts with spider web shaped cytoplasm. We diagnosed this tumor as well differentiated liposarcoma.

Esophageal Neoplasms↗
PubMed1991

[Studies on 5-FU concentration in serum and prostate cancer tissue after oral administration of UFT].

The serum, urine and tissue concentrations of 1-(2-tetrahydrofuryl)-5-fluorouracil (FT), 5-fluorouracil (5-FU) and uracil were estimated in 11 patients with prostate cancer (4 cases treated by total prostatectomy and 7 cases by transurethral resection (TUR-P) after oral administration of UFT. The concentration of FT, 5-FU and uracil in the tumor tissue (micrograms/g) were 5.920 +/- 5.902, 0.018 +/- 0.012 (T/S; 2.20) and 7.785 +/- 4.151 in 4 patients treated by total prostatectomy and 1.943 +/- 1.355, 0.024 +/- 0.010 (T/S; 1.46) and 4.616 +/- 2.848 in 7 patients treated by transurethral resection of prostate. The concentrations of FT, 5-FU and uracil in the tumor tissue did not increase as compared with those in normal tissue in 4 cases treated by total prostatectomy.

Administration, Oral↗
PubMed1991

[Cholangiographic studies on bile duct branches of the caudate lobe in resected cases with biliary tract carcinoma involving the hepatic hilus].

Diagnostic value of the cholangiography was studied for carcinoma of the biliary tract involving the hepatic hilus, and special attention was paid on the cholangiogram of the bile duct branches (B1) of the caudate lobe. Cholangiograms of B1 were compared with pathologic findings in 42 (27 bile duct carcinomas, 15 gallbladder carcinomas) of 43 cases of biliary tract carcinomas. Sixty-four of B1 in the 42 cases could be studied radiologically and histopathologically. The findings of the root of B1 were classified into 4 groups: group A, not stenotic; group B, short segmental stenosis; group C, long segmental stenosis and group D, poorly imaged. Carcinoma invasion was found in 6 of 18 of group B, and in 9 of 16 of group C. Carcinoma was confirmed near the root of B1 in the remaining 7 of the 16 group C. Carcinoma invasion was found in 20 of 21 of group D, and invasion was suspected in the remaining one. Carcinomas were found in the root of B1 in all cases of poorly imaged or long segmental stenosis of B1, and in 33% of short segmental stenosis of B1. Therefore caudate lobe resection should be performed for carcinoma of the biliary tract involving the hepatic hilus.

Adult↗
PubMed1991

Systemic amyloidosis in transgenic mice carrying the human mutant transthyretin (Met30) gene. Pathologic similarity to human familial amyloidotic polyneuropathy, type I.

To analyze the pathologic processes of amyloid deposition in type I familial amyloidotic polyneuropathy (FAP), mice were made transgenic by introducing the human mutant transthyretin (TTR) gene. In these transgenic mice, amyloid deposition started in the gastrointestinal tract, cardiovascular system, and kidneys 6 months after birth and extended to various other organs and tissues with advancing age. At age 24 months, the pattern of amyloid deposition was similar to that observed in human autopsy cases of FAP, except for its absence in the choroid plexus and in the peripheral and autonomic nervous systems. Amyloid deposition was shown to be composed of human mutant TTR and, in addition, mouse serum amyloid P component. These results clearly indicate that human variant TTR produced in transgenic mice deposits is a major component of amyloid fibrils in various organs and tissues. Thus this animal model is useful for analyzing how amyloid deposition initiates and proceeds in FAP.

Amyloid↗
PubMed1991

[Therapeutic effect of ranimustine(MCNU) on myeloproliferative disorder and chronic myelomonocytic leukemia].

Seventeen patients with myeloproliferative disorders and one patient with chronic myelomonocytic leukemia (CMMoL) were treated with ranimustine++ (MCNU), and the efficacy was evaluated. MCNU was given intravenously by drip infusion at an usual dose of 100 approximately 150 mg with intervals arranged according to the counts of peripheral blood cells. A complete remission was achieved in all 10 patients with chronic myelogenous leukemia (CML) in chronic phase. In three of patients with polycythemia vera (PV) the excellent effects were obtained, and the other 2 cases showed moderate effect. An excellent effect was obtained in both 2 patients with essential thrombocythemia (ET). A patient with CMMoL revealed partial remission. The overall efficacy rate was 100%. The cases with CML needed more long term and much more dose of the drug in order to get remission compared with PV and ET. After remission in both PV and ET, well controlled states were maintained for a relatively long period with no additional administration. In CMMoL, MCNU combined with 6-mercaptopurine also showed remarkable anti-tumor effects. It suggests that MCNU may be one of the useful drugs for the treatment of CMMoL. The side effects observed with MCNU were a slight degree of nausea and vomiting (28%), however they showed no trouble on carrying out the therapy.

Adult↗