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Biomedical subjects

S Tsunoda

Publications and source records attributed to S Tsunoda.

At least 145 records · Page 8Linked to original sources
PubMed1994

Strategies to improve the outcome of carotid endarterectomy.

The outcomes of carotid endarterectomy (CEA) including long-term results in 121 patients (126 procedures) were retrospectively analyzed to identify the causes of operative morbidity. The angiographic internal carotid artery (ICA) stenosis was severe (> 70%) in 62 patients and moderate (50-70%) with ulceration in 64. The arterial wall was sutured primarily in 91 patients and with patch graft in 35. The outcomes 3 months after operation were good recovery in 86 patients, moderately disabled in 20, severely disabled in 11, and death in four. Three patients suffered operative morbidity (2.5%). During follow-up, three patients (2.6%) suffered transient ischemic attack on the operative side due to middle cerebral artery stenosis (50%) or ICA occlusion at the origin, and recurrent stenosis (40%) of the common carotid artery and ICA (1 each). In the latter two cases, the artery was primarily sutured. Improved therapeutic results require use of patch vein graft for the arterial wall suture, checking of the CEA patency, and prevention of intracranial ischemic events and hemorrhage due to associated lesions.

Adult↗
PubMed1994

[A case of central pontine myelinolysis and extrapontine myelinolysis during rapid correction of hypernatremia].

A 69-year-old woman was admitted because of severe dehydration due to anorexia. Consciousness disturbance was found to be due to severe abnormalities of serum electrolyte balance, but recovered quickly by correcting the hyperosmolality. While the initial serum sodium value of 186 mEq/L was corrected to 139 mEq/L in 5 days, locked-in syndrome, bilateral hand tremor and tetraparesis appeared. Brain magnetic resonance imaging (MRI) revealed symmetrically high signal intensity areas on T2-weighted images and low signal intensity areas on T1-weighted images in central part of pons and bilateral middle cerebellar peduncles. One and a half month later, these neurologic symptoms were improved and the MRI abnormalities also disappeared. Auditory brain stem responses which showed prolongations of III to V wave peak to peak latency at the onset returned to normal. It is noted in this case that central pontine myelinolysis (CPM) and extrapontine myelipolysis (EPM) appeared during the period of rapid correction of hypernatremia. Although it is known CPM and EPM are caused by hypernatremia or the rapid correction of hyponatremia, there has been reported only one case of CPM and EPM after rapid correction of hypernatremia. According to the hypothesis of Norenberg, rapid rise in serum sodium may cause CPM and EPM, but if CPM and EPM are caused by the rapid correction of hypernatremia in this case, CPM and EPM may be caused by another pathogenesis of the disorder.

Aged↗
PubMed1994

Different gene expression of mouse transforming growth factor alpha between pregnant mammary glands and mammary tumors in C3H/He mice.

Mouse transforming growth factor alpha (TGF alpha) gene expression was determined by reverse transcriptase-polymerase chain reaction (RT-PCR) method in pregnant mammary glands and mammary tumors in C3H/He mice. Both normal pregnant and tumorous mammary tissues expressed mRNA for mouse TGF alpha. When primers from rat TGF alpha cDNA sequence as well as those in the previous report [12] were used, the PCR amplified products were the same sizes in both normal pregnant mammary gland and tumor. However, there were obviously different PCR products between pregnant mammary gland and tumor in case of using primers according to the mouse TGF alpha cDNA sequence. In tumors, various sizes of PCR products were detected in addition of a predicted size. This is unlikely the experimental artifact, but the polymorphic TGF alpha gene expression is induced in mammary tumors.

Animals↗
PubMed1994

[Effects of SN-38 in combination with other anticancer agents against Dauji cells].

To investigate the effects of CPT-11 in combination with other anticancer agents, a human Burkitt's lymphoma cell line, Dauji, was incubated for 3 days in the presence of SN-38 (active substance of CPT-11) and the combined drug and cell growth inhibition was determined by MTT assay. The effects of the drug combinations at ID50 were then analyzed by isobologram (Steel and Peckham). A supra-additive (synergistic) effect was observed for SN-38 in combination with carboplatin, cisplatin, cytosine arabinoside, and mitomycin C. An additive effect was observed for its combination with bleomycin, etoposide, 5-fluorouracil, and mitoxantrone. Additive and sub-additive (antagonistic) effects were observed in combination with doxorubicin. A Sub-additive effect was observed in combination with methotrexate and vincristine.

Antineoplastic Agents, Phytogenic↗
PubMed1994

[Malignant parasagittal meningioma appearing as a large subcutaneous mass].

We present a rare case of malignant meningioma appearing as an extracranial soft-tissue mass. A 34-year-old male was admitted with left parietal subcutaneous soft-tissue mass. Neurological examination on admission revealed right leg monoparesis and papilledema. Skull X rays showed hyperostosis of the left parietal bone. There was no evidence of bony destruction. CT and MRI showed a tumor with a large intracranial component, which was homogeneously enhanced. The tumor was totally removed by left ostoplastic craniotomy. The light-microscopic examination showed a meningothelial meningioma accompanied by malignant components with necrotic foci and mitotic figures. Tumor cells had invaded all the layers of the skull via the Haversian canals. We propose that hyperostosis with tumor invasion through all three layers of the skull should be considered as a malignant feature.

Adult↗
PubMed1994

[Diagnosis and treatment of acute undifferentiated leukemia and AML-MO].

To characterize AML-MO (MO) and acute undifferentiated leukemia (AUL) clinically, questionnaires were sent to nationwide hematology departments in May and August 1993. From 65 institutions, 71 MO cases (2.2% of acute leukemias, 3% of AML) and 19 AUL cases (0.4% of acute leukemias) were registered. Median age was 55 (15-81) years for MO and 38.5 (15-71) years for AUL, and the M/F sex ratio was 44:27 for MO and 19:2 for AUL. Of 48 cases examined for chromosome analysis, 24 (50%) were abnormal karyotypes. Of 15 cases examined for electron microscopic myeloperoxidase (MPO), 10 (67%) were positive, and of 9 cases examined for cytoplasmic antigen by anti-MPO antibody, 7 (78%), were positive. Examination of TdT, surface antigen of CD7 and CD34 were performed in 22, 61 and 43 cases and each positivity was 59, 51 and 86%, respectively. 3 of 18 cases showed rearrangement of immunoglobulin heavy chain gene and 2 of 13 cases showed rearrangement of T cell receptor beta gene. With the first-line induction chemotherapy, complete remission (CR) was obtained in 34 of 67 MO cases and in 7 of 18 AUL cases. Median CR duration and median survival for MO cases were 361 and 387 days and those for AUL were 541 and 578 days, respectively. The remission rates were 61% for 54 cases treated with AML chemotherapy regimens and 38% for 13 cases treated with ALL chemotherapy regimens. 9 cases of MO and AUL who received bone marrow transplantation (BMT) had excellently good prognosis compared with non-BMT group.

Adolescent↗
PubMed1994

[A multicentric glioma exhibiting three supratentorial lesions].

We reported a multicentric glioma having three separate lesions in the cerebrum. A 75-year old man was hospitalized with progressive disorientation. Computed tomography demonstrated two lesions in the left temporal lobe and the right frontal lobe. Magnetic resonance image disclosed one more lesion in the right occipital lobe. 2-staged operative procedures were performed for the left temporal and the right frontal tumors. It was histologically proven that one was glioblastoma and the other was anaplastic astrocytoma. The patient subsequently underwent radiotherapy and chemotherapy. Most multicentric gliomas are diagnosed in autopsy. Therefore it should be stressed that diagnosis is best made by biopsy or surgery. We discussed what therapy we should use for this fatal disease.

Aged↗
PubMed1993

mSlo, a complex mouse gene encoding "maxi" calcium-activated potassium channels.

Complementary DNAs (cDNAs) from mSlo, a gene encoding calcium-activated potassium channels, were isolated from mouse brain and skeletal muscle, sequenced, and expressed in Xenopus oocytes. The mSlo-encoded channel resembled "maxi" or BK (high conductance) channel types; single channel conductance was 272 picosiemens with symmetrical potassium concentrations. Whole cell and single channel currents were blocked by charybdotoxin, iberiotoxin, and tetraethylammonium ion. A large number of variant mSlo cDNAs were isolated, indicating that several diverse mammalian BK channel types are produced by a single gene.

Alternative Splicing↗
PubMed1993

Microneurographic analysis of muscle sympathetic nerve activity in amyotrophic lateral sclerosis.

Muscle sympathetic nerve activity by (microneurograph) blood pressure and heart rate has been studied in patients with amyotrophic lateral sclerosis and in age-matched normal subjects (controls) at rest and during head-up tilt. Muscle sympathetic nerve activity in amyotrophic lateral sclerosis patients was significantly increased at rest unlike controls. There was no correlation between muscle sympathetic nerve activity and age in the patients with amyotrophic lateral sclerosis. Elevated muscle sympathetic nerve activity was present mainly in younger patients. There were no differences between blood pressure or heart rate in either group at rest or during head-up tilt in amyotrophic lateral sclerosis. The increase in muscle sympathetic nerve activity following tilt in the amyotrophic lateral sclerosis patients was less than in the controls, but they had no postural hypotension. The possible reasons for this observation of increased muscle sympathetic nerve activity at rest in amyotrophic lateral sclerosis are discussed.

Adult↗
PubMed1993

Suprasellar embryonal carcinoma which developed ten years after local radiation therapy for pineal germinoma.

We recently encountered a case of suprasellar embryonal carcinoma which developed 10 years after local radiation therapy for pineal germinoma. This 29-year-old male was admitted because of abnormal behavior, disturbed consciousness, and increased intracranial pressure. Computed tomography and magnetic resonance imaging disclosed a tumor spreading from the suprasellar region to the third ventricle and the anterior horn of the left lateral ventricle, accompanied by fresh hemorrhage within the tumor. He underwent subtotal removal of the tumor, followed by chemotherapy with cisplatin and etoposide. The tumor was histologically rated as embryonal carcinoma with differentiation into yolk sac tumor and choriocarcinoma.

Adult↗
PubMed1993

The effect of a new calcium antagonist, TA3090 (clentiazem), on experimental transient focal cerebral ischemia in cats.

BACKGROUND AND PURPOSE: TA3090 (Clentiazem) has been shown to have cerebrovascular protective properties in three experimental studies. An in vivo investigation was undertaken to determine its effects on pial arteries and cerebral blood flow and its therapeutic value in transient focal cerebral ischemia. METHODS: This experiment was divided into two protocols. In the first, 200 or 400 micrograms/kg per hour TA3090 was administered continuously for 3 hours in cats without ischemic insult (n = 6 for each group). The effects on pial arteries and cerebral blood flow were estimated. In the second protocol, 400 micrograms/kg per hour TA3090 (treated group, n = 14) or physiological saline (control group, n = 10) was administered 5 minutes before 1 hour of middle cerebral artery occlusion in cats. The effects on the pial arteries and cerebral blood flow were observed continuously, followed by autoradiography for a quantitative measurement of cerebral blood flow 5 hours after middle cerebral artery recirculation. The volumes of the cerebral edema and infarct were estimated by planimetry from cerebral preparations made for histological examination. RESULTS: Pial arteries dilated by up to approximately 10% in the 400-micrograms group and 3% in the 200-micrograms group 30 minutes after administration of TA3090. Increases in cerebral blood flow of about 10% in the 400-micrograms group and 2% in the 200-micrograms group were demonstrated with laser Doppler flowmetry. In the second protocol, dilatation of pial arteries was significantly smaller during and after the ischemic insult in the treated group compared with the control group (p < 0.01). Cerebral blood flow decreased less significantly during ischemia (p < 0.01 at the end of ischemia) and increased less significantly after ischemia (p < 0.01 at the end) in the treated group compared with the control group. Autoradiography showed a more remarkable increase in cerebral blood flow due to luxury perfusion in the cerebral cortex, which was mainly perfused by the middle cerebral artery on the affected side in the control group (p < 0.01). Cerebral blood flow in the cerebral cortex, thalamus, and caudate nucleus on the contralateral side of the treated group increased by about 20% more than that of the control group (p < 0.05). Cerebral edema and infarction were much smaller in the treated group than in the control group (p < 0.01). CONCLUSIONS: 1) TA3090 dilates pial arteries and increases cerebral blood flow in normal brain regions in a dose-response fashion; 2) in ischemic regions compared with those in untreated animals, TA3090 results in a lesser reduction of cerebral blood flow during ischemia and in a lesser degree of hyperemia during reperfusion; 3) TA3090 is associated with less pial artery dilatation during ischemia, presumably due to improved collateral flow; and 4) the improved hemodynamic state with TA3090 is associated with significant reduction of cerebral edema and infarct size.

Animals↗
PubMed1993

Clinical studies of de novo aneurysms.

Although multiple cerebral aneurysms ae well recognized, a new aneurysm has only rarely been documented after successful treatment for an aneurysm elsewhere. In our consecutive series of 986 patients with intracranial saccular arterial aneurysm collected from 1975 to 1990, nine patients who had previously unverified (hence, de novo) intracranial aneurysms and ruptures at intervals of 4 to 7.5 years after clipping of an initial aneurysm are presented here. All nine had undergone successful treatment of a previous aneurysm; preoperative and postoperative angiography showed not only successful clipping of the first aneurysm but also no incidence of multiple aneurysms. These patients had suffered from hypertension before their second admission. Seven of the nine patients were treated surgically. All patients had experienced angiographical or symptomatic vasospasm after the first subarachnoid hemorrhage. In the second admission however, seven patients who underwent the surgery for a new aneurysm suffered from no vasospasm in spite of the prominent second subarachnoid hemorrhage. Two of the nine patients died of primary brain damage due to the hemorrhage and underwent necropsy. A histological study of a new aneurysm demonstrated the same findings as that of a usual saccular aneurysm. This clinical study of our patients suggests that it is important to control blood pressure for protection against a new aneurysm formation.

Adult↗
PubMed1993

First incidence of multilocular echinococcosis in a race horse in Japan.

Nodular hepatic lesions caused by larval Echinococcus multilocularis were found in a four-year-old female thoroughbred race horse born and raised in Hokkaido. Before detection of the infection, the infected animal was transported around Honshu for racing. The present disclosure of hydatidosis in a race horse raises concern over the potential danger of spreading the infection throughout Japan by horses possibly infected in Hokkaido.

Adrenal Glands↗
PubMed1993

Bleeding tendency caused by the deposit of amyloid substance in the perivascular region.

A 55-year-old woman, who had systemic amyloidosis associated with multiple myeloma, had sudden development of hematomas of her lip and upper eye lid. There was no evidence of deterioration of multiple myeloma, thrombocytopenia nor deficiency of coagulation factors. Biopsy specimen showed the deposit of amyloid substance in the dermis and perivascular region. The bleeding tendency in this patient with myeloma was likely due to the deposit of amyloid substance in the vascular wall; improvement was achieved with administration of hemostatic agents.

Adrenochrome↗
PubMed1993

Clinicopathological study on craniopharyngioma with sebaceous differentiation.

We presented 2 cases of craniopharyngioma, which showed sebaceous differentiation. Both cases shared the following features: 1) neuroradiological detection of a cystic tumor accompanied by calcification, 2) clear yellowish fluid detected in the cyst during surgery, 3) histological rating as an adamantinomatous type, 4) the presence of a nest-like distribution of multivacuolated cells in the innermost layer of the cyst.

Child↗
PubMed1993

[Muscle sympathetic nerve activity (MSNA) in a patient with tetanus].

Autonomic nervous function was studied in a 57-year-old female patient with tetanus of mild degree, by recording muscle sympathetic nerve activity (MSNA) using the microneurographic method, as well as by measuring blood pressure, heart rate and plasma content of norepinephrine (NE). No apparent clinical signs of autonomic dysfunction were observed. Recording of MSNA on the 7th hospital day revealed decreased discharge rates compared with age-matched healthy subjects, indicating suppressed sympathetic nerve function. The decreased MSNA returned to closely normal level after 3 months, when the clinical symptoms and signs were almost completely cleared up. Previous studies have shown facilitated sympathetic nerve function, while some sympathetic nerves remain suppressed, and therefore unstable cardiovascular dysfunction might be elicited in tetanus.

Female↗