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Biomedical subjects

T Goto

Publications and source records attributed to T Goto.

At least 487 records · Page 27Linked to original sources
PubMed1994

[A case of hydronephrosis caused by renal stones with elevated serum levels of CA-19-9 and CA-125].

A case of hydronephrosis caused by renal stones with elevated serum levels of carbohydrate antigens 19-9 (CA-19-9) and 125 (CA-125) is reported. A 74-year-old woman was hospitalized with pyelonephritis. The results of computerized tomography and endoscopy suggested that the patient did not have pancreatic or ovarian cancer, but laboratory tests were significant for serum CA-19-9 greater than 1,000 U/ml (normal less than 37) and serum CA-125 78 U/ml (normal less than 35), which are markers for such tumors. Abdominal X-ray films showed stones in the pelvis of the right kidney. Excretory urography showed that the right kidney was not functioning. Computerized tomography showed severe right hydronephrosis with a thin renal cortex. Complete obstruction of the ureteropelvic junction of the kidney was seen by retrograde pyelography. During percutaneous pyelography, aspiration of the pelvic urine was done, and the sample had a high concentration of CA-19-9 (250,000 U/ml), but no cancer cells. The patients underwent right nephrectomy. The pelvic urine was tested for both CA-19-9 and CA-125 this time, and both were high (190,000 U/ml and 5,100 U/ml, respectively). Pathological evaluation showed no evidence of a malignant tumor. The epithelium lining the renal pelvis was stained for both CA-19-9 and CA-125 using the avidin-biotin-peroxidase complex method. Serum levels of the markers returned to normal after nephrectomy.

Aged↗
PubMed1994

[Closed circuit anesthesia: a perspective in clinical practice].

"Care for the Earth" is a topic which everyone on this planet has to keep in mind, and anesthesiologist is no exception. More and more emphasis has been placed on minimization of air pollution. This inevitably influences our daily practice of anesthesia since many gaseous and volatile anesthetics are air pollutants. It is, therefore, high time to review closed circuit anesthesia (CCA), because CCA produces minimal (or, by definition, no) waste of anesthetics. Based on our extensive experience since 1977, we believe that CCA is not only safe to perform but also easy to learn once the differences and similarities between CCA and semi-closed circuit anesthesia (SCA) are clearly understood. This review focuses on fundamental principles of CCA with emphasis on some new concepts on how anesthesiologists control the depth of anesthesia during CCA and SCA. We hope these concepts help the readers overcome the traditional but unfounded impression that CCA is a highly specialized mode of anesthesia.

Air Pollution↗
PubMed1994

Projection structures of human immunodeficiency virus type 1 (HIV-1) observed with high resolution electron cryo-microscopy.

An electron microscopical study was made of human immunodeficiency virus type 1 (HIV-1) in the unstained, frozen, hydrated state at liquid helium temperature. The findings were compared with those obtained from negative staining and ultrathin sectioning. Electron cryo-microscopy confirms and extended the findings obtained by conventional methods. In particular, the virus is shown to be globular, the lipid membrane is clearly resolved as a bi-layer and the bi-layer was demonstrated to be non-uniform in width. The projections studied in the bi-layer are clearly observed to be knob-like and consist of a head, a stalk and a base.

Freezing↗
PubMed1994

[Protective effects of prostaglandin E1 on postoperative liver function after cardiac surgery].

Effects of prostaglandin E1 (PGE1) on liver function were studied in 72 patients who underwent mitral valve replacement (MVR) and coronary artery bypass grafting (CABG). The patients were divided into three groups: (A) patients with preoperative hepatic dysfunction who underwent MVR; (B) patients without previous hepatic dysfunction who underwent MVR; (C) patients without hepatic dysfunction who underwent CABG. About half of the patients in each group received PGE1 during the operation and postoperative period in the ICU. Change of serum GOT, GPT, albumin, total bilirubin, and cholinesterase (ChE) showed no difference between the patients with and without PGE1 administration in groups B and C. But, in group A, PGE1 administration significantly ameliorated the decrease of ChE, a condition which is usually observed in the first and second postoperative weeks after MVR. None of the patients showed severe hepatic dysfunction in the PGE1 group. One patient in the control group A revealed severe hepatic failure with high bilirubinemia and decreased ChE. These results suggest that the administration of PGE1 to patients with hepatic dysfunction, scheduled for MVR, might protect the liver from deterioration.

Aged↗
PubMed1994

[Closed circuit anesthesia: its foundation and application].

The basic theory of closed circuit anesthesia (CCA) was founded by Dr. H Lowe in 1970's. The introductory textbook he and his colleague wrote was published in 1981, which, surprisingly, has not been revised since then. Furthermore, there are no other monographs on this subject, reflecting a decline in the interest of many anesthesiologists in CCA. However, CCA has been drawing more and more attention recently because of the introduction of new and expensive inhalational anesthetics and growing concern over environmental pollution. In this review, we aimed at explaining the basis on which how Dr. Lowe derived his original theory of CCA called square root method, and what limitations this theory has in applying CCA to our clinical practice. Then, we proposed a practical modification of Lowe's approach, introducing a statistical method called "Bayesian updating" to predict a changing variables during anesthesia. We conclude this review by discussing future perspective of CCA, taking Xenon as an example of an ideal anesthetic agent that may be introduced into our clinical practice in the near future.

Anesthesia, Closed-Circuit↗
PubMed1994

Identical blood pressure levels and slower heart rates among nurses during night work and day work.

To investigate the effects of shift work on circadian BP variation, ambulatory 24h BP monitoring was performed during the day shift and night shift on 17 normotensive nurses. On both shifts, BP and heart rate increased in the working phase and decreased during sleep. The mean 24h BP and heart rate were identical in the two shifts. During sleep, BP was lower and the heart rate was slower in the day shift (night sleep) perhaps because of deeper sleep than during daytime sleep associated with the night shift. During work, BP was identical but the heart rate was significantly slower during the night shift. These data suggest that the circadian BP variation is determined largely by the sleep-wakefulness cycle and that the heart rate is also influenced by the internal body clock.

Adult↗
PubMed1994

[Clinical application of a third generation lithotripter (Modulith SL20) for urinary tract calculi].

A third generation lithotripter (Modulith SL20) was used for disintegration of upper urinary tract calculi. From April 1991 through March 1993, a total of 281 sessions were carried out on 212 patients with upper urinary tract calculi at Seichoukai Fuchu Hospital. One month after the last session, of the 141 patients evaluated, 55 (39.0%) were free from stone fragments and 52 (36.9%) had stone fragments equal to or smaller than 4 mm. The over-all successful rate was 75.9% and the success rate was excellent for lower ureteral stones. As side effects, there were no serious complications other than perinephritic hematoma which occurred in 2 patients. These findings clearly indicated that the Modulith SL20 lithotripter was highly useful for disintegration of calculi of the upper urinary tract.

Adult↗
PubMed1994

[Removal of infected total pacemaker system under extracorporeal circulation--a case report and review of the Japanese literature].

A 35-year-old male with sick sinus syndrome was complicated with recurrent local infection at the site of the generator pocket associate with a retained pacemaker lead, followed by septicemia presenting with Staphylococcus aureus. Several attempts to remove the lead via the implantation vein by direct traction were performed unsuccessfully because the leads were strongly adhered to the trabecula of the right ventricle. Repeated debridement employing antibiotic therapy was ineffective. As a last resort, we finally operated under extracorporeal circulation (ECC) 24 months after the first implantation and 22 months after initiation of the local infectious episode. As we found it difficult to remove the leads by traction even under direct vision, we used the vinyl chloride tube, which is a part of the ECC circuit, as a sheath for applying countertraction around the lead tip to prevent the myocardial wall from being torn and extracted together with the lead tip. The lead was removed successfully and a new epicardial lead was implanted. The postoperative course uneventful and no recurrence has occurred after 1 year. In reviewing the Japanese literature, 10 case, operated on under ECC to remove the infected retained leads, were described in detail. Among them, eight cases had undergone previous debridement including removal of the generator and the subcutaneous portion of the lead. It is clear that removal of all of the pacemaker system is necessary for eradication of infection. Adhesion of the lead to the wall is firm. Only one case besides ours succeeded in having its lead removed without requiring incision of the tissue around the lead tip.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

CD7+ stem cell leukemia/lymphoma. Features of a subgroup without circulating blast cells.

Recent advances in immunology have clarified the cellular origin of hematopoietic neoplasms. Blast cells with a CD7+ CD4- CD8- phenotype are demonstrated to originate from malignant pluripotent hematopoietic stem cells. In this article, the authors describe three rare cases, designated as a lymphoma type of CD7+ stem cell leukemia/lymphoma, with clinical features described below. All three patients were admitted with non-Hodgkin lymphoma with a 2-month to 4-month history of lymphadenopathy. Histologic examination of lymph nodes showed lymphoblastic lymphoma (LBL) in all patients. Bone marrow blast cells had an immunophenotype consistent with CD7+ CD4- CD8- acute leukemia, although abnormal cells were not observed in the peripheral blood during the course of the disease. One patient had a recurrence in the bone marrow, with myeloperoxidase-positive blast cells expressing myeloid differentiation antigens. Chromosomal analysis detected a common abnormal karyotype initially and at relapse. Furthermore, the same T-cell receptor gene rearrangement was found initially and at relapse, suggesting that these blast cells originated from the same pluripotent leukemic clone. Additional studies on more patients are required to determine the clinical significance of this group, including the difference from CD7+ stem cell leukemia/lymphoma with circulating blast cells (leukemic type) or LBL.

Acute Disease↗
PubMed1993

Inner architecture of human and simian immunodeficiency viruses.

The cores of human and simian immunodeficiency viruses (HIV and SIV) were observed by negative staining after isolation of the core with Nonidet P40 and glutaraldehyde. Four kinds of cores were found: asymmetric and symmetric sectoral shapes, a bar shape, and a triangular shape. These results were confirmed by the examination of ultrathin sections of whole virions. In some virions, the connection between the core and the envelope was observed after freeze fracturing. Its structure was considered to be characteristic of an intermediate stage of viral maturation. The HIV-1 core was reacted with anti-HIV-1 p24 mouse monoclonal antibody.

Animals↗
PubMed1993

Responses of neurons in the rostral ventrolateral medulla of the cat to natural vestibular stimulation.

To investigate the neural substrate of vestibulo-sympathetic reflexes, we studied the responses of neurons in the rostral ventrolateral medulla (RVLM) of decerebrate cats to natural stimulation of the labyrinth in vertical and horizontal planes. The RVLM is a major source of excitatory inputs to sympathetic preganglionic neurons. The animals used in these studies were baroreceptor-denervated and vagotomized and had a cervical spinal transection so that inputs from tilt-sensitive receptors outside of the labyrinth did not influence the units we recorded. Of the 38 neurons whose type of vertical vestibular inputs could be classified, the majority (27) received signals mainly from otolith organs. Only 4 of the neurons received inputs predominantly from vertical semicircular canals, and 7 were classified as having convergent inputs from otoliths and canals that were spatially aligned (2 cells) or misaligned (5 cells). In addition, only 2 of 68 neurons tested responded to sinusoidal horizontal rotations in a manner typical of brainstem neurons that receive inputs from the horizontal semicircular canals. Thus, the vestibular inputs to the RVLM appear to come mainly from otolith receptors. In labyrinthectomized cats, we were unable to locate neurons with responses to tilt similar to those of cells recorded in labyrinth-intact cats, confirming that the responses attributed to vertical vestibular inputs were produced by signals from the labyrinth. In animals whose semicircular canals had been rendered dysfunctional by plugging, we only recorded responses similar to those of neurons classified as having mainly otolith inputs in canal-intact animals, indicating that the dynamic behavior of these cells does not depend upon canal inputs. The presence of otolith inputs to the RVLM is consistent with the hypothesis that this region mediates vestibulo-sympathetic reflexes involved in correcting posturally-related changes in blood pressure.

Animals↗
PubMed1993

A new bioactive glass--ceramic as a coating material on titanium alloy.

Apatite--wollastonite-containing glass--ceramic (A--W . GC) has a strong ability to bond to bone and relatively high mechanical strength. Therefore, as a bulk material it has recently been applied clinically even in load-bearing sites. In this study, we modified A--W . GC by altering its composition ratio with the removal of CaF 2 and the addition of B 2O 3, and examined the potential use of the resulting new glass--ceramic as a material for coating on a titanium (Ti) alloy. The bioactivity of this new coating (NC) material and its bonding ability to bone were investigated mechanically and histologically. After implantation of the Ti alloy plate coated with this material into the tibiae of rabbits for 2, 3, 4, 8, and 25 weeks, a detaching test was performed. The detaching failure load of the NC plates was compared with those of A--W . GC plates, hydroxyapatite (HA) plates, and uncoated Ti alloy plates implanted in the same way. The failure load of NC was as high as that of A--W . GC for all periods, whereas it was significantly higher at 3 and 4 weeks than that of HA. Uncoated Ti alloy showed lower failure loads for all periods, differing significantly from the other materials. There was no breakage or detachment of the coating layer observed after the detaching test. Histological examinations by CMR, Giemsa surface staining, and SEM-EPMA showed that NC bonded directly to bone without any intervening soft tissue layer. A calcium--phosphorus-rich layer (apatite layer) was observed within the coating layer, as is the case in A--W . GC. These results indicate that this new glass--ceramic has earlier bone-bonding ability and high mechanical strength, making it a promising coating material.

Animals↗