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Biomedical subjects

T Komatsu

Publications and source records attributed to T Komatsu.

At least 235 records · Page 13Linked to original sources

[Spike discharge detected by intra-arterial electroencephalography from intra-arterial guide wire in temporal lobe epilepsy].

The implantation of electrodes for intracranial electroencephalography (EEG) recording as presurgical evaluation of patients with intractable epilepsy is at present most important for planning epilepsy surgery. This method is most effective in temporal lobe epilepsy. We carried out intracranial EEG by means of insulated micro guide wire for endovascular surgery in two temporal lobe epilepsy cases, and spike discharges could be detected in lesional medial temporal lobe. Case 1 is a 29 year-old-male suffered from intractable complex partial seizure (CPS) for 18 years. He was diagnosed as left temporal lobe epilepsy and performed removal of amygdala, hippocampus, parahippocampal gyrus and fusiform gyrus. Case 2 is a 16 year-old-lady suffered from drug resistant CPS for 4 years. Under the diagnosis of right temporal lobe epilepsy, temporal lobectomy was performed. As the presurgical evaluation, under the implantation of subdural strip electrode in both cases, we carried intra-arterial EEG after angiography. Seeker Lite-10 guide wire was insulated with Tracker-10 unibody infusion catheter at sphenoidal portion of middle cerebral artery, and frequent interictal spike discharge was detected in lesional medial temporal lobes by two methods simultaneously.

Adolescent↗

[Verrucous carcinoma of the penis: a case report and MRI findings].

A 54-year-old male visited our cancer center with the chief complaint of penile tumor in May, 1992. Magnetic resonance imaging (MRI) demonstrated a penile tumor and showed that this tumor invaded the submucosa but neither corpora cavernosa nor corpus spongiosum. Partial penectomy was performed in June, 1992. Histopathological examination of the resected tumor showed verrucous carcinoma. MRI was useful to investigate the degree of invasion of the penile tumor.

Carcinoma, Papillary↗

[A case of Behçet's disease associated with aortic regurgitation].

A 42-year-old woman was admitted to our hospital because of anterior chest discomfort on exercise. She had already been diagnosed as having a complete form of Behçet's disease. On auscultation, there was a grade 2/6 diastolic regurgitant murmur along the left sternal border. Echocardiogram and pulse doppler led to the diagnosis of aortic regurgitation and mitral fluttering in diastole. Left ventriculography disclosed an enlarged left ventricular chamber, but the ejection fraction was 60% within the normal range. Aortography confirmed the diagnosis of aortic regurgitation (III.) and dilatation of the ascending aorta. The coronary arteriogram was normal. An endomyocardial biopsy of the right ventricular wall revealed mild hypertrophy of the myocardial fibers and interstitial edema. In this report, we discussed a case of Behçet's disease with reference to 28 cases reported in the medical literature in Japan.

Adult↗

[A case of advance colon cancer responding to sequential methotrexate and 5-fluorouracil therapy].

A 60-year-old female was diagnosed by X-ray examination and endoscopy as ascending colon cancer. Ultrasonography and computed tomography revealed two metastatic tumors in the liver. Abdominal surgery revealed peritoneal disseminations, massive lymph node metastasis and direct invasion of the transverse colon and ileum. From pathological examination the diagnosis was moderately differentiated adenocarcinoma. After right hemi-colectomy, sequential methotrexate and 5-fluorouracil therapy as well as oral administration of UFT, liver metastasis disappeared and no sign of ascites was found in this case. Complete response time was over 8 months. There have been no severe complications.

Adenocarcinoma↗

Lipid microsphere containing lipophilic heme: preparation and oxygen transportation under physiological conditions.

Lipophilic heme (1-laurylimidazole-ligated 5,10,15,20-tetrakis(alpha, alpha, alpha, alpha-o- pivalamidophenyl)porphinatoiron(II) complex) is solubilized in lipid (triglyceride) at high concentrations and emulsified with a phospholipid in physiological salt solution, giving a deeply red-colored suspension of lipid microspheres (approx. 250 nm in diameter). The heme forms an oxygen adduct in a similar manner as oxyhemoglobin and the lipid microspheres take up and release oxygen reversibly at 37 degrees C in the aqueous medium. The oxygen-transporting ability is comparable with that of the red blood cell. Intravenous injection of the heme/lipid microsphere solution to rabbits demonstrates that it transports oxygen even in vivo and that it is cleared from the blood stream with a half-life time of approx. 1 h.

Animals↗

Axial skeletal malformations induced by acetazolamide in rabbits.

In order to evaluate the teratogenic potential of acetazolamide in rabbits, three groups of 18 artificially inseminated females were treated orally with 50, 100, or 150 mg/kg/day of acetazolamide on days 6-18 of gestation. These doses induced maternal acidosis and electrolyte changes, consistent with those reported in rats and considered to be a result of carbonic anhydrase inhibition, as well as reductions in maternal body weight gain. At cesarean sections, average fetal body weights in the acetazolamide groups were dose-dependently decreased compared with controls. There were no effects of acetazolamide on embryonic survival or external morphology of live fetuses. In the fetal skeletal examination, thoracic and lumbar vertebral malformations occurred in 0.7%, 3.9%, and 6.1% of fetuses in the 50, 100, and 150 mg/kg/day groups, respectively, compared with none in the control group. In addition, missing vertebra was seen in a small number of fetuses in the 100 and 150 mg/kg/day groups. These axial skeletal malformations were, in some cases, associated with costal malformations. These results indicate that acetazolamide at maternotoxic doses can produce axial skeletal malformations in the rabbit.

Acetazolamide↗

Effects of fentanyl-diazepam-pancuronium anesthesia on heart rate variability: a spectral analysis.

The effects of induction of anesthesia with fentanyl, 62.1 +/- 7.9 micrograms/kg, diazepam, 0.21 +/- 0.08 mg/kg, and pancuronium on beat-to-beat heart rate variations were studied in seven patients undergoing cardiac surgery. Spectral analysis was used to determine the intensity of the variations in each of the two main frequency bands in which variations are known to occur: (1) high-frequency band, mediated by the parasympathetic nervous system, at the frequency band of respiration, and (2) the low-frequency band, mediated by both sympathetic and parasympathetic nervous systems, at 0.04-0.12 Hz. Both the mean low- and high-frequency band areas were significantly decreased after induction of anesthesia. The ratio of high-to-low frequency band areas increased significantly after induction of anesthesia, from 45% to 62% (P less than 0.05). These results suggest that fentanyl-diazepam-pancuronium anesthesia decreases total autonomic nervous system activity and alters the balance between parasympathetic and sympathetic activities. Thus, spectral analysis of heart rate variations during anesthesia may provide a quantitative measure of assessing the activity of the autonomic nervous system.

Adult↗

Hepatic venous hemoglobin oxygen saturation predicts liver dysfunction after hepatectomy.

A fiberoptic flow-directed catheter inserted into the hepatic vein continuously measures hepatic venous oxygen hemoglobin saturation (ShvO2). This study determined whether intraoperatively measured ShvO2 could predict postoperative serum activities of aminotransferases and patient outcome in 83 patients undergoing hepatectomy. The duration of intraoperative ShvO2 less than or equal to 10, 20, 30, 40, and 50% was calculated in each case. Significant increases in postoperative serum aminotransferases were associated with more than 1, 11, 31, 51, and 181 min of duration of ShvO2 less than or equal to 10, 20, 30, 40, and 50%, respectively. The incidence of postoperative liver failure significantly increased when the duration of ShvO2 less than or equal to 20, 30, and 40% exceeded 11, 31, and 51 min, respectively. The mortality from liver failure was significantly higher when the duration of ShvO2 less than or equal to 30 and 40% exceeded 31 and 51 min, respectively. Therefore, intraoperative monitoring of ShvO2 may predict not only the increase in postoperative serum aminotransferases but also patient outcome in terms of postoperative liver failure after hepatectomy.

Adult↗

Spectral analysis of heart rate variability during isoflurane anesthesia.

The autonomic nervous system is an important neural control system for maintaining cardiovascular stability in humans. Analysis of heart rate variations may provide important clinical information on the influence of anesthesia on the autonomic nervous system and the central nervous system. Therefore, the effects of 1.0, 1.5, and 2.0 minimum alveolar concentrations of isoflurane anesthesia on beat-to-beat heart rate variations were studied in ten patients (ASA Physical Status 1). Spectral analysis was used to determine the intensity of the variations. For each power spectrum, the frequency components were identified as follows: 1) the parasympathetically mediated respiratory component (0.15-0.4 Hz) and 2) both parasympathetically and sympathetically mediated components (0.04-0.15 Hz). The latter was subdivided into the low-frequency component (0.04-0.09 Hz) of vasomotor origin and the mid-frequency component (0.09-0.15 Hz) of baroreceptor origin. Marked reductions in the power of heart rate variations, at all frequencies, were found during isoflurane anesthesia, indicating isoflurane decreased total autonomic nervous system activity. Isoflurane decreased the high-frequency and mid-frequency components in a concentration-dependent manner. The low-frequency component increased transiently at 1.5 minimum alveolar concentrations concomitant with the burst suppression in the electroencephalogram. The ratio of mid-frequency to high-frequency components did not change significantly during isoflurane anesthesia compared with the awake period. These frequency characteristics of heart rate variations during isoflurane anesthesia suggest there are dose-related decreases in autonomic nervous system activity in both the vagus and the cardiac sympathetic nerves.

Adult↗

Infection of macaque monkeys with a chimeric human and simian immunodeficiency virus.

Two macaque monkeys were inoculated with a chimeric human and simian immunodeficiency virus carrying the tat, rev, vpu and env genes of human immunodeficiency virus type 1. Infectious virus was recovered from one of the monkeys at 2 and 6 weeks post-infection. The hybrid nature of the isolated viruses was verified by Southern and Western blotting analyses. Both of the monkeys infected with the chimera elicited a humoral antibody response against the virus.

Animals↗

Relationship between gallium 67 citrate scanning and transferrin receptor expression in lung diseases.

The uptake of gallium 67 (67Ga) into cells is postulated to be through transferrin receptors (TFR) of 67Ga combined with transferrin. We studied the relationship between gallium 67 citrate scanning (67Ga scan) and immunohistochemical TFR expression in lungs of nine patients with lung cancer and eight patients with diffuse interstitial lung diseases. We found that lung cancer tissues of positive 67Ga scan expressed TFR, but those of a negative scan did not. In all of the five patients with idiopathic pulmonary fibrosis (IPF), TFR were expressed on the membrane of alveolar macrophages that formed clusters. However, TFR were not expressed in lymphocytes, neutrophils, type 2 alveolar epithelial cells, and endothelial cells. In two patients with sarcoidosis and a patient with pneumoconiosis, TFR were expressed positively only on the membrane of foamy alveolar macrophages and epithelioid cells of granuloma. These findings suggest that 67Ga-citrate initially combines with transferrin in the blood and then the complex is incorporated into cells through TFR. Therefore, 67Ga scan could be positive when cells have TFR and one should be able to observe cancer cells, clusters of alveolar macrophages, and epithelioid cells through the imaging of 67Ga scan in lung cancer and diffuse interstitial lung diseases.

Citrates↗

Different susceptibilities to attenuated poliovirus of cynomolgus monkeys from the Philippines and other Southeast Asian countries.

Susceptibilities to attenuated poliovirus of cynomolgus monkeys were assessed by the intraspinal inoculation method with the same single bulk lot as the reference for each of the three poliovirus types. The lesion-inducing virus dose in the spinal cord of 50% of monkeys inoculated (LID50) varied widely from 10(6.4) to lower than 10(2.5), the difference being as much as 10,000-fold, depending on the birth place of the monkey. The birth places of the monkeys used were traced and categorized into the following three districts; the peninsular region, Indonesia and the Philippines. The LID50 value of the attenuated poliovirus in the monkeys from the Philippines were much lower than those in the monkeys from the other two districts.

Animals↗

[A case of atrial standstill associated with combined valvular disease].

A 62-year-old man was admitted to our hospital because of general malaise. The chest X-ray film showed severe cardiomegaly (CTR = 81%). The electrocardiogram demonstrated absence of P wave in 12-leads and regular junctional rhythm with incomplete right bundle branch block. Echocardiogram and color Doppler led to the diagnosis of mitral stenosis and regurgitation, tricuspid regurgitation with enlarged left and right atrium. Cardiac catheterization study revealed elevation of the pulmonary artery wedge pressure and the right atrial pressure without A wave. In the electrophysiologic study, no atrial electrical activity was recorded in the right atrium and the coronary sinus. However, when atrial pacing was attempted at multiple sites with stimulum strength of 10 V, there was no atrial activity at various sites. We considered that the atrial overload due to combined valvular disease for seventeen years had resulted in total and persistent atrial standstill. In this report, we discussed atrial standstill in 67 cases recorded in the medical literatures in our country.

Echocardiography↗