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Biomedical subjects

S Murakami

Publications and source records attributed to S Murakami.

At least 613 records · Page 34Linked to original sources
PubMed1991

[Disseminated intravascular coagulation after transurethral ureterolithotripsy: a case report].

We experienced a case of disseminated intravascular coagulation (DIC) following transurethral ureterolithotripsy (TUL). A 78-year-old woman was referred to our hospital with the complaints of fever and urinary tract infection. Urine culture showed positive E. coli and antibiotics were given. Radiologic findings revealed a left renal stone. The patient underwent TUL. After the operation acute renal failure occurred. Laboratory data revealed DIC on the next day. In spite of intensive therapy the patient died. Pathological findings showed that acute renal failure was caused by DIC. It is important that we should note the risk of DIC after TUL.

Acute Kidney Injury↗
PubMed1991

[Effects of upper thoracic epidural anesthesia on hemodynamics and oxygen supply-demand relationship in hypovolemic dogs].

The purpose of the present study is to assess the influence of upper thoracic epidural anesthesia (TEA) on hemodynamics, the systemic oxygen supply-demand relationship, and several indications of stress in the presence of preexisting hypovolemia. Sixteen adult mongrel dogs were anesthetized with halothane and nitrous oxide, and blood was withdrawn at the rate of 3 ml.kg-1.min-1 for 10 min. The dogs were randomly assigned to two groups; one receiving TEA (TEA group, n = 8), and the other without (controls, n = 8). Mean arterial blood pressure, heart rate, arterial concentrations of epinephrine and norepinephrine remained significantly lower (P less than 0.05) in the TEA group than in the controls during the 100-min observation period following the start of TEA. Cardiac index, oxygen supply-demand ratio (O2 delivery/O2 consumption) and arterial lactate concentration showed no significant intergroup differences at any point during observation. By contrast, there was a significant difference in arterial pH between the TEA group (7.22 +/- 0.05, mean +/- SD) and the controls (7.15 +/- 0.08) after 100 min of TEA. These results indicate that in hypovolemic dogs anesthetized with halothane and nitrous oxide, TEA affects the acid-base balance favorably without significantly influencing the systemic oxygen supply-demand relationship.

Anesthesia, Epidural↗
PubMed1991

[Successful mitral valve replacement in osteogenesis imperfecta--a case report].

A 34-year-old man with osteogenesis imperfecta who underwent successful mitral valve replacement due to mitral regurgitation was reported. Cardiac disease associated with osteogenesis imperfecta is very rare and only fifteen patients were operated under the extracorporeal circulation previously. While excessive hemorrhage due to tissue fragility was observed in 7 of 15 patients, perioperative course of the case reported here was completely uneventful. The difference of hemorrhagic tendency as well as etiology of osteogenesis imperfecta will be defined according to the advance of technology in collagen genetics and biochemistry in future.

Adult↗
PubMed1991

[Results of radical nephrectomy associated with regional lymphadenectomy for renal cell carcinoma].

Between January, 1975 and December, 1989, 86 patients with renal cell carcinoma received radical nephrectomy associated with lymphadenectomy at our institutions. Pathological examination revealed lymph node metastasis in 15 patients (17.4%). The incidence of lymph node metastasis increased in accordance with the aggravation of tumor stage (p less than 0.01) and grade (p less than 0.05). Patients with a rapidly growing tumor showed higher incidence of lymph node metastasis than patients with a slow growing tumor (p less than 0.01). Regional lymph node metastases were found in 3 of the 41 patients with a slow growing tumor. Since these 3 patients are surviving with no evidence of disease for 38.7 months on average, the regional lymphadenectomy was considered to have been effective for their survival. Nine of the 25 patients with a rapid growing tumor had progressive lymph node metastasis. Four of them had apparent tumor thrombi as well as lymph node metastasis, and 2 of them had distant metastasis. These patients showed poor prognosis even after operation. Lymphadenectomy was of no value to the patients with apparent tumor thrombi and/or distant metastasis.

Adult↗
PubMed1991

[Chronic lymphocytic leukemia with bilateral exophthalmos and visual disturbance].

A 61-year-old male was admitted to our hospital because of progressive bilateral exophthalmos and visual disturbance. He was diagnosed as chronic lymphocytic leukemia (CLL) with stage I of Rai system. Ophthalmologic examinations suggested that CLL cells might have invaded diffusely to bilateral orbits. Radiation to orbital lesions might result in other ophthalmologic complications such as cataract, therefore we tried to treat him with chemotherapy alone. As a result, combination chemotherapy consisting of vincristine, cyclophosphamide, prednisolone and doxorubicin (VEPA) and additional daily oral administration of cyclophosphamide were effective enough for his ophthalmologic recovery.

Exophthalmos↗
PubMed1991

Philadelphia chromosome positive precursor B-cell acute lymphoblastic leukemia with a translocation t(2;14)(p13;q32).

A female patient with precursor B-cell acute lymphoblastic leukemia (precursor B-ALL) was analyzed cytogenetically. Karyotyping of the leukemic cells showed a Philadelphia chromosome (Ph1), and also showed a translocation between 2p13 and 14q32, which is thought to be specific for children with B-cell chronic lymphocytic leukemia. DNA analysis with both conventional and pulsed-field gel electrophoresis revealed the rearrangement of the c-abl gene, the BCR gene outside the 5.8 kb breakpoint cluster region (bcr or M-BCR), and the comigration of an abnormal Not I pHabl 5' and 3'-bcr fragment, indicating the presence of BCR/c-abl recombination. The JH gene was rearranged, but the JK gene showed a germline configuration, as with previously reported cases with a t(2;14). This case is the first report of a patient with Ph1-positive precursor B-ALL, in whom a specific translocation t(2;14)(p13;q32) is found simultaneously.

Adult↗
PubMed1991

[Role of carcinoembryonic antigen, carbohydrate antigen 19-9 and cytology of bile in diagnosis of biliary and pancreatic cancer].

To evaluate the clinical value in diagnosis of biliary and pancreatic cancer carcinoembryonic antigen (CEA), carbohydrate antigen (CA19-9) and cytology in the bile were examined in 343 patients with benign biliary disease and 71 patients with biliary and pancreatic cancer. An abnormal CEA level was defined as a level of more than 500 ng/ml in the gallbladder bile and 40 ng/ml in the bile duct bile. Increased bile CEA levels were observed in 50.0% in 22 patients with bile duct cancer, 60.0% in 20 with gallbladder cancer and 23.8% in 21 with pancreas cancer. False positive rate in 343 patients with benign diseases was only 1.2%. Bile CA19-9 levels were measured in 195 patients with benign disease and 30 with malignancy. However, the overlap between the values of the 2 groups was too great for differentiation of malignancy from benign disease. The positive rates of bile cytology were 52.2% in 23 patients with bile duct cancer, 40.0% in 15 with gallbladder cancer and 27.3% in 22 with pancreatic cancer. The diagnostic accuracies of combined assessment of bile CEA and cytology were 68.0% in 25 patients with bile duct cancer, 77.3% in 22 with gallbladder cancer and 37.5% in 24 with pancreatic cancer. The sensitivity of this combined test was 60.6% (43/71), and the specificity was 98.8% (339/343). This combined test is considered to be reliable screening test especially for biliary cancer.

Antigens, Tumor-Associated, Carbohydrate↗
PubMed1991

[A case of angiomatous meningioma near the geniculate ganglion].

A 57-year-old male was admitted with pulsatile tinnitus and hearing disturbance of the right ear and right peripheral facial palsy. Otological examination revealed a pulsatile red mass in his right ear and right conductive hearing disturbance. CT and MRI showed the mass lesion at his right middle fossa near the geniculate ganglion. Right external carotid angiogram disclosed a tumor stain fed by the middle meningeal artery. The tumor was removed via a combination of subtemporal and transmastoidal approaches. Histologically, this tumor was diagnosed as angiomatous meningioma partly with meningotheliomatous meningioma. Meningioma in this region is very rare. We discussed its clinical and radiological characteristics in comparison with chemodectoma and facial neurinoma at the geniculate ganglion.

Angiography↗
PubMed1991

[A case of congenital bronchial atresia with obstructive pneumonia accompanied with partial anomalous pulmonary venous drainage].

A 25-year-old male was admitted with productive cough and an abnormal shadow on chest X-ray film which showed a cylindrical shadow near the left hilum and consolidation in the markedly hyperlucent left upper lung field. The cylindrical shadow appeared to be located in left S1+2 but bronchographic examination showed independence of the branches of B1+2. Furthermore, pulmonary venography by DSA showed that the left upper pulmonary vein entered the left brachiocephalic vein. The patient underwent left partial lobectomy under a diagnosis of congenital bronchial atresia with partial anomalous pulmonary venous drainage. Pathological examination of the resected lung revealed obstructive pneumonia in the over-inflated lung zone, probably induced through collateral airways.

Abnormalities, Multiple↗
PubMed1991

[A case of pulmonary aspergillosis presenting pulmonary bulla and eosinophilic pneumonia].

A rare case of a 25-year-old man with pulmonary aspergillosis is reported. Pulmonary bulla and eosinophilic pneumonia in the right upper lobe were diagnosed by chest roentgenogram and transbronchial lung biopsy. Because the patient developed infective bullae during steroid therapy, we performed transcutaneous thoracic drainage and right upper lobectomy. The resected lung tissue contained numerous hyphae of Aspergillus. Around the hyphae of Aspergillus, granulomatous reaction and eosinophilic infiltration were observed. Antibodies against Aspergillus were detected in the serum of the patient. The number of peripheral blood eosinophils decreased after right upper lobectomy. These findings suggest that pulmonary bullae and eosinophilic pneumonia may be a rare manifestation of pulmonary aspergillosis.

Adult↗
PubMed1991

[A case of infiltrative transitional cell carcinoma of the kidney with hypercalcemia].

A 73-year-old man was admitted to our hospital with chief complaint of macrohematuria. Computerized tomography revealed enlargement of right kidney, tumor thrombi and lymph nodal involvement. Distant metastases were found in liver, lung and pelvis. We performed conservative therapy including right renal embolization. However, serum calcium levels continued to increase. Patient died from renal failure and pneumonia after 2 months, and autopsy was performed. Histological examination revealed infiltrative transitional cell carcinoma of the right kidney. PTH like peptide was measured 1 ng/gram wet tissue from the primary tumor and 16.6 ng/gram wet tissue from the metastatic liver tumor.

Aged↗
PubMed1991

[The efficacy of VAD chemotherapy for refractory lymphoid malignancies].

Thirty patients with refractory lymphoid malignancies [multiple myeloma (MM): 8, plasma cell leukemia (PCL): 2, acute lymphocytic leukemia (ALL): 5, chronic myelogenous leukemia in blast crisis: 1, chronic lymphocytic leukemia in blast crisis: 1, adult T-cell leukemia: 1, non-Hodgkin lymphoma (NHL): 9, Hodgkin's disease (HD): 3] were treated with VAD regimen (vincristine, doxorubicin, dexamethasone). Of 28 evaluable patients, 4 patients achieved complete response or remission [MM1, ALL1, NHL1, HD1], 10 attained partial response or remission [MM5, PCL1, NHL3, HD1], and 2 patients with MM attained minor response. The remission duration ranged from 1 month to over 14 months. The response rate was high in patients with MM (75%) and lymphoma (60%), however 4 patients with T-cell malignancies achieved no response except one with NHL. In three patients who showed resistance to VAD, diltiazem was administered in addition to VAD and one patient with MM had response. Atrio-ventricular block was also observed in one patient during the period of diltiazem administration. Nine patients developed documented infections, 5 of which suffered from candida infections. From these observations, we concluded that VAD regimen might be useful as a salvage therapy especially in patients with MM and lymphoma.

Adult↗
PubMed1991

[Successful pregnancy after 6 years complete remission in patient with acute myeloblastic leukemia].

A 25-year-old woman was diagnosed as acute myeloblastic leukemia (M1 in FAB classification) in May 1983, and treated with DCMP regimen, which led to the complete remission. Intensification therapies and maintenance therapy with OK-432 were continued until August 1988, and 10 months later she conceived. She delivered a healthy 2,680 g male baby at 36th week of pregnancy by Cesarean section because of abruptio placentae. This case suggests that normal pregnancy is possible in patients with acute leukemia who received anti-cancer drugs.

Adult↗
PubMed1991

[Successful excision of right ventricular myxoma].

A 17-year-old woman with right ventricular myxoma is reported. The diagnosis was made by means of two-dimensional echocardiography. Under extracorporeal circulation, the tumor was successfully excised through a right atrial approach. Right ventricular myxoma is a rare disease but when the exact diagnosis has been established, urgent operation is mandatory because of the impending danger of sudden death from pulmonary embolism or obstruction of the outflow tract by the tumor.

Adolescent↗