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Biomedical subjects

S Matsuno

Publications and source records attributed to S Matsuno.

At least 199 records · Page 11Linked to original sources

Continuous regional arterial infusion of protease inhibitor and antibiotics in acute necrotizing pancreatitis.

PURPOSE: This study was conducted to determine whether continuous regional arterial infusion (CRAI) of the protease inhibitor, nafamostat mesylate, in acute necrotizing pancreatitis, would reduce mortality. In addition, the effectiveness of CRAI of the antibiotic imipenem in combination with nafamostat was investigated for its effect in preventing secondary infection of the pancreatic necrotic tissue. PATIENTS AND METHODS: Fifty- three patients with acute necrotizing pancreatitis were divided into three groups: Group I, 16 patients who were referred >8 days after disease onset, received intravenous nafamostat and antibiotics; Group II, 22 patients referred within 7 days, received nafamostat via CRAI, and antibiotics intravenously; Group III, 15 patients referred within 7 days, received both nafamostat and imipenem via CRAI. RESULTS: The mortality rates in Group II (13.6%) and group III (6.7%) were significantly reduced, as compared with that in group I (43.8%). The incidence of infection of pancreatic necrosis in group III (0%) was significantly lower than those in group I (50%) and in group II (22.8%). CONCLUSION: CRAI of nafamostat and imipenem in acute necrotizing pancreatitis was effective in reducing mortality and preventing the development of pancreatic infection.

Acute Disease↗

The somatic mutation frequency of the transforming growth factor beta receptor type II gene varies widely among different cancers with microsatellite instability.

Disruption of the DNA mismatch repair system, characterized by microsatellite instability (MSI), plays an important role in the course of human carcinogenesis. Frequent somatic mutations in a polyadenine (poly(A)) tract and two GT repeats within the coding region of the transforming growth factor beta (TGFbeta) receptor II (RII) gene were reported in colorectal cancers with MSI. We examined mutations of RII in cancers of various organs with MSI and found deletions at the poly(A) tract in eight of nine (89%) gastric cancers and four of five (80%) colorectal cancers. In contrast, no mutations were found in cancers of the pancreas, endometrium, or lungs. These results suggest that TGFbeta-mediated growth control plays a very important role in the stomach and colorectum.

Adult↗

Haemorrhagic shock and encephalopathy associated with rotavirus infection.

We report on a 21-month-old girl with a haemorrhagic shock and encephalopathy who survived. Rotavirus genomic ribonucleic acid was detected by reverse transcription polymerase chain reaction in stool, blood and cerebrospinal fluid. Serum antibody titres of the rotavirus were also high. Plasmapheresis had a stabilizing effect on the course of the disease. This case indicates that rotavirus infection may play an important role in the devastating cascade that occurs in some patients with this syndrome. The findings suggest that extensive investigation for rotavirus infection, particularly infection of the central nervous system, should be carried out in patients with haemorrhagic shock and encephalopathy.

Brain Diseases↗

A new in vitro model of specific targeting therapy of cancer: retargeting of PWM-LAK cells with bispecific antibodies greatly enhances cytotoxicity to hepatocellular carcinoma.

For the purpose of establishing a new in vitro model of adoptive immunotherapy, we synthesized two kinds of bispecific antibodies (BsAbs), i.e., (OK x L) BsAbs constructed with both OKT-3 (anti-CD3) and L-7-6 (anti-HCC), and (3G x L) BsAbs constructed with 3-G-8 (anti-CD16) and L-7-6 antibodies. These two BsAbs, having pairs of binding arms on their single molecule, showed similar binding to target cells as the parental monoclonal antibodies (OKT-3, 3-G-8 and L-7-6), when examined with FACS. Newly devised in vitro cytotoxicity tests revealed that LAK or PWM-stimulated LAK (PWM-LAK) cells did not show any significant cytotoxic activity to HCC cells, while both effector cells equally showed greatly enhanced cytotoxicity to HCC even at a low effector/target (0.3) in the presence of BsAbs (OK x L) for the efficient retargeting of the effector cells. Inasmuch as PWM-LAK cells proliferate in vitro 3-5 times faster than LAK cells, adoptive immunotherapy using PWM-LAK cells in combination with (OK x L) BsAbs should be very promising.

Antibodies, Bispecific↗

Chronic bile diversion to the urinary bladder enhances cholecystokinin release and suppresses gastric inhibitory polypeptide release in dogs.

The role of intestinal luminal bile on cholecystokinin (CCK) and gastric inhibitory polypeptide (GIP) release was examined in dogs with chronic external bile diversion. In 6 mongrel dogs, cholecysto-jejuno-cystostomy (C-J-C) was performed using a small segment of the middle small intestine interposed between the gallbladder and urinary bladder with section of the common bile duct. Butter dissolved in 30 ml of lukewarm water was orally ingested before surgery, and same amount of butter solution with or without graded volumes of canine bile were orally ingested between four to six weeks after C-J-C surgery. Increases in both plasma triglyceride and GIP levels after butter ingestion were almost completely abolished by C-J-C, but they were restored by oral bile feeding in a volume-dependent manner. Both basal and fat-stimulated CCK release were enhanced significantly by C-J-C, and oral bile feeding inhibited fat-stimulated CCK release by bile in a dose dependent manner. These data suggest that intraluminal bile regulates basal and fat-stimulated CCK release and fat-stimulated GIP release in dogs.

Animals↗

Analysis of the derangement of the pancreatic microcirculation in a rat caerulein pancreatitis model using an intravital microscope system.

In order to clarify the derangement of the pancreatic microcirculation in acute pancreatitis, the pancreatic microcirculation in caerulein pancreatitis was monitored intravitally and the roles of bradykinin and nitric oxide were examined using bradkykinin B2 receptor antagonist, HOE140. Under an intravital microscope, the pancreatic microcirculation was observed 2 or 6 hr after the induction of acute pancreatitis. HOE140 was administered 30 min before the induction of acute pancreatitis. The videoimages were taken into the computer, and the value of grayscale was measured with imaging software to quantify the degree of extravasation. Extravasation in the postcapillary venules was remarkable and the velocity in pancreatic terminal arterioles decreased significantly. However, the adherence of leukocytes was not observed until 6 hr after the induction. Both the extension of extravasation and the decrease of velocity were prevented by HOE140. The levels of nitric oxides in the pancreatic tissue declined and this decline was not influenced by HOE140. Bradykinin participates mainly in the regulation of vascular permeability in the early stage of caerulein pancreatitis. Further, the impairment of pancreatic microcirculation may play a key role in the onset and development of acute pancreatitis.

Acute Disease↗

Usefulness of Japanese staging in the prognosis of patients treated operatively for adenocarcinoma of the head of the pancreas.

BACKGROUND: Differences in the clinical staging in Japan from that of the Union Internationale Contre le Cancer (UICC) staging system may account for discrepancies in the prognosis of carcinoma of the pancreas between Japan and the United States of America. STUDY DESIGN: This study compares the usefulness of Japanese staging with the UICC staging in 1,689 patients who underwent resection for carcinoma of the pancreatic head registered with the Japan Pancreas Society. RESULTS: The survival rate was correlated with the Japanese stage classification. The survival rate of patients with T4 tumors was surprisingly better than for those with T2 or T3 tumors. The extent of lymph node involvement and of extrapancreatic tissue invasion reflected the prognosis. The UICC staging system did not reflect differences in prognosis among the four stages, especially between stages II and III. CONCLUSIONS: To establish a more practical and universal staging system for carcinoma of the pancreas, the Japanese system may offer improvements in predicting the prognosis of American or European patients with this disease.

Adenocarcinoma↗

[Pylorus-preserving gastrectomy for early gastric cancer].

Pylorus-preserving gastrectomy (PPG) was originally proposed by Maki et al for gastric ulcer. Recently this operation with lymph node dissection has been adopted for patients with early gastric cancer locating at antrum and body of the stomach in Japan. But standard procedure of this operation has not been established yet. Grade of lymph node dissection, preservation of pyloric branch and indication criteria are fairly dependent on each surgeon when PPG is applied for gastric cancer. Although the results of this operation is not accumulated enough, it is considered that this operation may have benefits for decrease of postoperative chronic morbidity with acceptable cancer curativity as compared to conventional distal gastrectomy, Billroth-I procedure.

Gastrectomy↗

[Limy bile].

Explore the source record for details and available documents.

Calcium Carbonate↗

[A case of isolated congenital mitral insufficiency].

A 1-year and 8-month-old girl admitted to our hospital because of wheeze and dyspnea. Echocardiogram and cardiac catheterization confirmed isolated congenital mitral insufficiency with pulmonary hypertension. She was treated with reconstructive surgery consisting of suture of clefted anterior mitral leaflet and annuloplasty. Her postoperative course was uneventual and mitral regurgitation was remarkably improved.

Female↗

[Successful repair of right atrial rupture due to nonpenetrating trauma of the chest].

A 24-year-old male was brought to our hospital after being injured in a traffic accident. On arrival, his blood pressure was 70/44 mmHg and his pulse rate was 135/min and regular. Chest X-p revealed cardiomegaly but there was no pleural effusion or bone fracture. Echocardiogram revealed cardiac tamponade and he was diagnosed as cardiac rupture due to non penetrating trauma. Under midline sternotomy, right atrial rupture was repaired. The patient developed cardiac arrest lasting approximately 8 minutes during anesthetic induction, so he needed to be ventilated for 8 days. However his postoperative course was not so eventful and he was discharged 38 days after surgery without any neurophysiological disturbance.

Accidents, Traffic↗

[The problem of 19 mm St. Jude Medical valve prosthesis in the small aortic annuls--19 mm St. Jude Medical valve vs 23 mm St. Jude Medical valve].

We compared the results of 19 mm SJM aortic valve replacements with those of 23 mm SJM aortic valve replacements conducted the same period. [Material & Method] The subjects were 21 patients who underwent valve replacement with a 19 mm SJM prosthesis (the SJM19A group). The age ranged among 16 and 65-year-old, mean of 51. The body surface area was 1.24 to 1.76 m2, mean of 1.48 m2. The post-operative follow-up period was 156 months at maximum and 44 months on average. We compared the SJM19A group with the SJM23A group by chest X-ray and echocardiography. [Results] Two patients in the SJM19A group died soon after surgery. Of the other patient, 19 were categorized NYHA I and one in NYHA II classification in their late phase. Arrhythmia of Lown IVa developed in one patient. The cardio-thoracic ratio decreased from preoperative 60% in the late phase after surgery (p < 0.002) in the SJM19A group, although there was no significant difference with that in the SJM23A group. Echocardiographic improvement in left ventricular hypertrophy was considerable between before and late after surgery in the SJM19A group, while it was not significantly different between the SJM19A and SJM23A group. The mean value of aorta-left ventricle pressure difference in the late stage was 32 mmHg in the SJM19A group and significantly different from the value in the SJM23A group (p < 0.001). This pressure difference tended to be greater as the follow-up period was progressed, while the percentage decrease in the myocardial mass of the left ventricle tended to decreased with longer follow-up period. This data suggests that an increasing level of aorta-left ventricle pressure difference should raise little problem in the mid-term late stage after surgery but possibly cause a serious problem in the long term. Clinical observation should be continued over a long period of time after surgery.

Adolescent↗

Modified procedure with a surgical stapler for construction of a Pavlov pouch in dogs.

An aim of this study was to establish a simple method for the construction of a Pavlov pouch that is free of fistula formation between the main part of the stomach and the pouch, yet preserves maximal vagal innervation. The Pavlov pouch (vagally innervated gastric pouch) was constructed from the greater curvature of the gastric corpus at the level of the splenic hilus in four dogs. The plane between the mucosal and seromuscular layers was dissected bluntly along the medial margin of the pouch. A surgical stapler was introduced into the space between the mucosal and seromuscular layers, and the pouch was completely separated from the main part of the stomach enterically at the mucosal level but remained connected via the seromuscular layers. All dogs survived the operation and lost minimal weight; fistulas were not found between the remnant stomach and the pouch at necropsy 6 to 8 weeks later. Gastric acid secretion for 30 to 90 min after insulin-induced hypoglycemia, which increases vagal tone, was significantly increased compared to that before insulin injection, confirming preservation of vagal innervation to the pouch. Our technique to create a Pavlov pouch is superior to the methods reported previously because of its simplicity, lower prevalence of fistula formation, and reliable preservation of vagal innervation to the pouch.

Animals↗

[The role of screening for carcinoma of the pancreas].

We discussed the possibility of the screening programs for the early detection in carcinoma of the pancreas. Several trials of screening have been conducted for the outpatients with diabetes mellitus, jaundice or upper abdominal pain by means of serum erastase-1, amylase and CA19-9 levels and the ultrasonography. The trials could detect 37 patients of 4250 (1.3%), 47 of 423,905 (0.011%) and 89 of 3585 (2.4%) with carcinoma of the pancreas. Despite effective screening program is not available, the screening carries the potential for improvement of the resectability and the mortality in the patients with carcinoma of the pancreas.

Biomarkers, Tumor↗

Pseudoaneurysm of the left ventricle following repair for ventricular septal perforation.

The patient was a 64-year-old man who was treated surgically for an infarct-related ventricular septal perforation. Pseudoaneurysm of the left ventricle was recognized on the 38th postoperative day. Emergency surgery was performed. It seemed that insufficient resection of the infarcted myocardium was performed during the initial surgery to avoid narrowing the ventricular dimension by direct closure of the left ventricle, but this resulted in pseudoaneurysm of the left ventricle. Left ventricular free wall plasty with a patch should be performed during the initial surgery.

Aneurysm, False↗

Validity of the Karnofsky Performance Status in an HIV-infected sample.

The Karnofsky Performance Status (KPS) is the most widely used health status measure in human immunodeficiency virus (HIV) medicine and research. Because there are limited data on KPS metric properties in this setting, we present evidence of the construct validity of the KPS in a sample of HIV-infected persons using data from the AIDS Time-Oriented Health Outcome Study (ATHOS). The sample consisted of 160 primarily white, homosexual/bisexual men with a mean age of 45 years and a mean KPS score of 82 (range, 40-100). Ninety percent were classified in Centers for Disease Control (CDC) clinical category B or C. Pearson's product-moment correlations were strong between the KPS and measures of global health status, physical disability, numbers of symptoms, CDC clinical category, social function, days off work, and energy/fatigue (r = 0.39-0.52, p < 0.0001). Correlations with measures of mental health and cognition were less impressive but statistically significant. Analysis of variance followed by Student Newman-Keuls test showed significant differences among three KPS groupings for global health status but not for physical disability. Regression analysis indicated three significant variables accounting for KPS variance: visual analogue global health status (27%), days off work (10%), and energy/fatigue (1.7%). We conclude that the upper range of the KPS reflects global health status better than physical performance and much better than psychosocial constructs, in persons with HIV infection. Further research examining the ability of the KPS to detect clinically significant change over time is needed.

Adult↗