[Emergency anesthesia of a patient with acute myocardial infarction complicated with perforation of the ventricular septum].
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Anesthesia↗
Biomedical subjects
T Kudo
Publications and source records attributed to T Kudo.
[Right ventricular dysplasia: clinical features compared with dilated cardiomyopathy].
Five patients with right ventricular dysplasia (RVD) and 28 patients with predominantly left sided dilated cardiomyopathy (DCM) were studied. RVD was characterised by syncope, recurrent sustained ventricular tachycardia, which typically had a left bundle branch block pattern on the surface electrocardiogram, right heart failure, and faint or absence of the right ventricular free wall on the myocardial scintigraphy. Two-dimensional echocardiographic, radionuclide angiographic, and contrast ventriculographic studies were typical of the right ventricular abnormalities in both Uhl's anomaly and arrhythmogenic right ventricular dysplasia. Two of them were died suddenly. Pathologic examinations showed "parchment-like" thinning of portions of the right ventricular free wall and its replacement by adipose tissue, although such degenerations were not found in the septum and the left ventricle. By contrast, DCM was characterised by exertional dyspnea and short run ventricular tachycardia, most of which had a right bundle branch block pattern. Ten of them had left ventricular myocardial defects on the scintigraphy, of whom five died suddenly. Hemodynamic data showed that left ventricular dysfunction was predominant more than right ventricle. Thus we postulate that these two syndromes are manifestations of a congenital, pathophysiologic process - the "involved right or left ventricle" syndrome.
Adult↗
[Metabolic and endocrine responses to anesthesia and surgery during trimetaphan infusion].
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Adult↗
[Left atrial myxoma--report of a case having cardiac preoperative symptoms for twenty-six years].
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Female↗
[Hypertrophic obstructive cardiomyopathy with extensive myocardial fibrosis: case report with autopsy].
An autopsy case of hypertrophic obstructive cardiomyopathy with extensive myocardial fibrosis is reported in a 43-year-old male. His mother died suddenly at 55. At the age of 39 the patient felt fatigue and feverish sensation followed by dyspnea and palpitation on exertion. He responded to beta-blocker and was discharged on the 51st hospital day. He died suddenly during his work three years and one month after discharge. The heart weighs 700 g. The thickness of the ventricular septum measures up to 3.2 cm, and that of the left ventricular posterior wall 2.2 cm. Subaortic endocardium is moderately thickened. Many patchy fibroses of various sizes and broad linear fibroses are mainly observed in the ventricular septum and in the left ventricular free wall. Microscopic examination shows severe fascicular disarray of hypertrophied myocardial fibers in the ventricular septum and in a part of the left ventricular anterior wall. Pericardial fibrosis, granulation tissue with many capillaries, and slight lymphocytic infiltrate are also noted. These findings suggest that the patient have both congenital hypertrophic cardiomyopathy and myocarditis. There are following possibilities as regards the relation between the two: first, haphazard association of cardiomyopathy with myocarditis; secondly, myocarditis triggered the onset or progression, or both, of cardiomyopathy. He also had liver cirrhosis, probably alcoholic, which appears to accelerate the progression of myocardial disarray and fibrosis.
Adult↗
[Enhancing activity of bacterial preparations on blood flow in tumor tissue, with reference to cancer chemotherapy. Experimental and clinical studies].
The effect of treatment with bacterial preparations on blood flow in normal and malignant tissues was investigated, clinically and experimentally. The time course of the local effect of the preparations was recorded by Laser Doppler Velocimetry (LDV) via a probe on the surface of normal and malignant tissues directly over the injection site. Experimentally, no definite enhancement of blood flow with OK-432, a streptococcal preparation, was observed in nude mice. Clinically, intradermal administration of OK-432 or tuberculin (PPD) resulted in an approximate 11-or 4-fold increase in blood flow, respectively. The injection of OK-432 into malignant tissues, such as dermal cancer and breast cancer with direct extension to the skin, resulted in an approximate 3.5-fold increase. The results suggested that bacterial preparations can act as an adjuvant to enhance drug delivery to tumor tissue in cancer chemotherapy, and that the enhancement of blood supply is induced by immune response.
Adult↗
[Giant aneurysm of the right coronary artery with complete proximal obstruction: a case report].
A 46-year-old woman was admitted to our hospital for evaluation of oppressive chest pain and ECG abnormalities. Her ECG on admission showed old inferior myocardial infarction. Chest radiography on admission indicated cardiomegaly (cardiothoracic ratio was 60%). The echocardiogram showed compression of the right atrium, right ventricle, and tricuspid annulus by a tumor which was located between the liver and the heart. The tumor's echo density was heterogenous. Cardiac computed tomography showed compression of the tricuspid annulus by the tumor which was located anterior to the right atrium and the right ventricle. The tumor registered 65.1 HU and was not enhanced by contrast medium. These findings strongly suggested a giant right coronary aneurysm filled with thrombus, and this diagnosis was confirmed at surgery and pathologically. Coronary aneurysms are rarely diagnosed during life, and usually are incidental findings during coronary arteriography performed to evaluate myocardial infarction or angina pectoris. The coronary aneurysm of the present case was clearly and easily recognized using computed tomography and appeared as a pericardial tumor. Computed tomography may be helpful for observing the growth of tumor and thrombus formation within it.
Aneurysm↗
[Clinical studies with antimicrobic agent "Dolcol" for chronic prostatitis].
Chronic prostatitis is possibly the most common infectious disease in middle-aged men. Clinical investigation was made on 24 outpatients with chronic prostatitis at our department, during the period of October, 1983 to August, 1984. The diagnostic criterion of the prostatitis was detection of more than ten leukocytes per high power field on microscopic examination of the expressed prostatic secretion and urine after prostatic massage. Twenty-four patients with chronic prostatitis were treated with 2 tablets of Dolcol (Pipemidic acid, PPA) three times daily for 7-30 days. The effectiveness was evaluated by improvement of subjective symptoms and objective findings. The results of the therapy with PPA on chronic prostatitis were excellent in 8 patients (33.3%), good in 10 (41.7%), fair in 2 (8.3%), and poor in 4 (16.7%). The effective rate was 83.3%, while no side effects were noted. Therefore, PPA was suggested to be effective against chronic prostatitis.
Administration, Oral↗
Mechanisms for development of functional tricuspid regurgitation determined by pulsed Doppler and two-dimensional echocardiography.
Mechanisms for the development of functional tricuspid regurgitation (TR) were studied in 41 patients by ultrasound. The severity of TR was classified into 4 grades according to the extent of the regurgitant signal by pulsed Doppler echocardiography (echo). No TR signal was detected in 11 patients; the grade of TR was 1+ in 9 patients, 2+ in 10, 3+ in 8 and 4+ in 9. Using 2-dimensional echo, the tricuspid anular area was estimated from a horizontal and a sagittal diameter of the anulus, and systolic configurations of the tricuspid valve was observed. The tricuspid anular area corrected for body surface area increased with the grade of TR. Anterior displacement of the tips of the tricuspid leaflets was seen in 10 patients with TR of 2+ or greater severity, and its frequency also increased with the grade of TR. Loss of coaptation was seen in 3 patients with 4+ TR and malaligned coaptation was seen in 4 patients with TR of variable degrees. Tricuspid anular dilatation and anterior displacement of the tricuspid leaflet tips causes a separation between the leaflet tips and appears to be the main mechanisms for the development of functional TR. Malaligned coaptation also plays a role in the development of functional TR.
Echocardiography↗
Ascending aorta-bilateral femoral arteries bypass via preperitoneal route of ventral abdominal wall.
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Abdominal Muscles↗
Pathogenesis and clinical features of acute cholangitis accompanied by shock.
We investigated 91 cases of acute cholangitis, including 42 of severe cholangitis and 49 of mild cholangitis. The incidence of endotoxemia was 78.6 percent in 42 and 32.6 percent in the 49 patients. In the 42 with severe cholangitis, remarkable leukocytosis, thrombocytopenia, decrease of serum CH50, C3, plasma fibronectin and phagocytic index were characteristic. Disseminated intravascular coagulation (DIC) was observed in 76.2 percent. Since there was a positive correlation between platelet counts and levels of CH50 and C3, the decrease of platelet count, and the occurrence of DIC in patients with endotoxemia were thought to be closely related to the consumption of complements. There was no difference in mortality rate between nonsurgical treatment (57.8 percent) and the emergency bile drainage treatment (56.5 percent). The results of therapy depended on the degree of complicating DIC. We conclude that acute cholangitis was aggravated by endotoxemia and that severe cholangitis was accompanied by DIC induced by a decline in phylaxis.
Acute Disease↗
A duodenal duplication cyst communicated with an accessory pancreatic duct.
We treated a 49 year-old woman with acute pancreatitis, in whom there was an accessory pancreatic duct which opened into a duodenal duplication cyst. Epigastric pain associated with vomiting and fever were present. Laboratory data showed leukocytosis and hyperamylasemia. An upper G-I series revealed a stricture at the pyloric region. At operation a spherical mass of 6 cm in diameter was present between the greater curvature of the pyloric region and the head of the pancreas. The cyst was removed by hemigastrectomy and partial resection of the head of the pancreas. The accessory pancreatic duct opened into the cyst. Taking particular note of the communication with the pancreatic duct, this cyst was diagnosed as one of duodenal duplication. A duodenal duplication cyst communicating with the accessory pancreatic duct is rare and is dissimilar to any of the 20 cases of duodenal duplication reported in Japan since 1960.
Acute Disease↗
The effect of semantic plausibility on sentence comprehension in aphasia.
Tested were 50 aphasic patients (16 Broca's, 15 Wernicke's, 10 global, and 9 amnesic), 13 nonaphasic brain damaged patients, and 13 normal adults to evaluate the effect of semantic plausibility on sentence comprehension in active affirmative declarative sentences with a sentence-picture matching task. A plate of two pictures was provided for each stimulus sentence, and the subject was required to choose the picture corresponding to the sentence presented auditorily. Two types of sentences in terms of plausibility were prepared, i.e., probable sentences (P) describing common events in our daily life and improbable sentences (I) describing rare events. There were four kinds of combinations of a picture with the other to make a correct/(distractor) set, i.e., P/(P), P/(I), I/(P), and I/(I) constructions. The results indicated that probable sentences were more comprehensible than improbable sentences, and that the effect of semantic plausibility did not differ among aphasic types.
Adult↗
Phenotype characteristics of human B cells studied by Epstein-Barr virus infection. I. Immunoglobulin expression on human lymphoblastoid cells established from various lymphoid cells.
Forty-seven lymphoblastoid cell lines were established from human fetal lymphoid tissues, cord blood lymphocytes (CBL) and adult peripheral blood lymphocytes (PBL) by Epstein-Barr virus (EBV) infection. Their surface immunoglobulin (sIg), intracytoplasmic immunoglobulin (cIg) expression, and immunoglobulin (Ig) content in the culture supernatant were tested. Expression of sIgM, sIgG and sIgA were predominant on fetus-derived cell lines, while sIgD was the most prominent on CBL-derived cells. Though cIg expression did not vary between cell lines of different origin, Ig content in the culture supernatant differed greatly. Fetus- and CBL-derived cells secreted IgM exclusively, but PBL-derived cells secreted not only IgM, but also IgG and IgA abundantly. These results indicate that the lymphoblastoid cells established by EBV infection reflect the Ig phenotype of the cell from which they originated.
Cell Differentiation↗
Phenotype characteristics of human B cells studied by Epstein-Barr virus infection. II. C3 receptor switching during human B cell differentiation.
Our experiments showed that two C3 receptors (C3-R) appeared on membrane surfaces in a distinct sequence during the differentiation of human B cells. The experimental results supporting this conclusion were (1) the lymphoblastoid cells established from immature B cells expressed more EACm-R (C3bi and C3d receptors) than EACh-R (C3b receptor), (2) the lymphoblastoid cells originated from mature B cells showed more EACh-R than EACm-R, (3) the above characteristic expression of C3-R was demonstrated on every clone isolated in soft agar from cells in B cell lineage at various differentiation stages, indicating that a cell line consists of homogeneous population in terms of C3-R expression. From these results, it was concluded that C3-R switched from EACm-R to EACh-R during B cell differentiation.
B-Lymphocytes↗
Phenotype characteristics of human B cells studied by Epstein-Barr virus infection. III. In vitro modulation of C3 receptor expression on human lymphoid cells.
An addition of dimethyl sulfoxide (DMSO) in culture medium enhanced the expression of receptor (R) for EACh (C3b-R) of the lymphoblastoid cells derived from immature B cells which were expressing little or no EACh-R. EACm-R (C3bi- and C3d-R) on the lymphoblastoid cells of bone marrow cells decreased remarkably (25 to 5%) during short term cultivation, though other markers remained unchanged. In addition, C3-R expression of the lymphoblastoid cell lines from bone marrow cells, which were established by EBV infection before and after 4-day cultivation, was quite similar to that of the cell of origin. These results, in accordance with our previous paper (Kudo, T. and Tachibana, T. (1984) Immunol. Lett. 8,343-348), support the idea that the sequential switching of C3 receptors, EACm-R----EACh-R, occurs during B cell differentiation.
B-Lymphocytes↗
Cloning of leucine genes of alkalophilic Bacillus No. 221 in E. coli and B. subtilis.
The leucine genes of alkalophilic Bacillus No. 221 were cloned into the HindIII sites of pBR322 and pGR71, and recombinant plasmids pHK101 and pHK111 were constructed. The cloned 7.2 kb DNA consisting of HindIII fragments of 4.0 kb and 3.2 kb could substitute for leucine genes (alpha-isopropylmalate (alpha-IPM) synthetase gene, beta-IPM dehydrogenase gene, and alpha-IPM isomerase gene) of E. coli and B. subtilis, but not ilvB gene of B. subtilis. The 4.0 kb HindIII fragment could substitute for alpha-IPM synthetase gene of E. coli, and the 3.2 kb HindIII fragment could substitute for alpha-IPM isomerase gene of E. coli. Both 4.0 kb and 3.2 kb fragments are necessary to substitute for beta-IPM dehydrogenase gene. The expression of beta-IPM dehydrogenase gene of alkalophilic Bacillus No. 221 was repressed by the addition of leucine in the culture medium of B. subtilis carrying the plasmid pHK111. These results indicated that the 7.2 kb fragment contains the leucine gene cluster and its regulatory region.
3-Isopropylmalate Dehydrogenase↗
Molecular cloning and expression of cellulase genes of alkalophilic Bacillus sp. strain N-4 in Escherichia coli.
The genes for cellulases of alkalophilic Bacillus sp. strain N-4 were cloned in Escherichia coli with pBR322. Plasmids pNK1 and pNK2 were isolated from the transformants producing carboxymethyl cellulase, and the carboxymethyl cellulase genes cloned were in 2.0- and 2.8-kilobase-pair HindIII fragments, respectively. On the DNA level, the pNK1 fragment had a different restriction map from that of the pNK2 fragment, but the genomic hybridization experiments showed partial homology among these fragments. A total of 74 and 34% of the enzyme activities were observed in the periplasmic space of E. coli carrying the plasmids pNK1 and pNK2 , respectively. The carboxymethyl cellulase thus produced had broad pH activity curves (pH of 5 to 10.9) and was stable up to 75 degrees C.
Bacillus↗