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Biomedical subjects

T Matsuda

Publications and source records attributed to T Matsuda.

At least 721 records · Page 40Linked to original sources
PubMed1995

Bacteremia caused by the Bacteroides fragilis group in patients with hematologic diseases.

During a 22-year period, 13 patients with hematologic diseases developed bacteremia caused by the Bacteroides fragilis group, with a frequency which remained almost unchanged. Nine patients (69%) had polymicrobial infections. Acute leukemia was the most common underlying disease. The lower intestinal tract (necrotizing enterocolitis and anorectal abscesses) was the most common source of infection. Prior antibiotic therapy was the most frequent host condition before bacteremia, followed by cancer chemotherapy, neutropenia, thrombocytopenia and hypoproteinemia. Septic shock occurred only in seven patients with polymicrobial infections. Six patients, including five with shock, died within a week of onset, while the other seven survived for at least three weeks. Despite its clinical similarity to aerobic gram-negative infection, bacteremia due to the B. fragilis group may well, therefore, be suspected particularly when neutropenic patients who present with lower intestinal symptomatology develop a persistent fever unresponsive to the initial empiric antibiotic therapy.

Acute Disease↗
PubMed1995

[Management of epidural anesthesia in a patient with aortitis syndrome].

We report an anesthetic management of a patient with severe vascular occlusion case caused by Aortitis syndrome. The patient, 61 yr-old woman, was scheduled for sigmoidectomy. Her bilateral common carotid arteries and left main coronary artery were totally occluded, but she had been asymptomatic for over thirty years. Epidural anesthesia was chosen to provide pain control, cardiovascular stability, and also to maintain consciousness during operation for cerebral circulatory evaluation. Following intravenous administration of lactated Ringer's solution (about 1000 ml), epidural blockade was maintained with 1 to approximately 1.5% lidocaine and butorphanol. Our findings in this case indicate that it is important for coronary and cerebral perfusion to have normal central venous pressure (preload) and arterial pressure during sympathetic blockade resulting from epidural anesthesia.

Adenocarcinoma↗
PubMed1995

[Effect of ulinastatin on the free radical during cardiopulmonary bypass].

Cardiopulmonary bypass (CPB) involves many factors for generating free radicals. It is difficult to detect free radical directly in clinical situations. Vitamin E is recognized as an intrinsic radical scavenger. We examined the change of vitamin E level to prove indirectly the evidence of free radical generation during CPB. Moreover, we investigated the effect of ulinastatin on the free radical during CPB by determining the vitamin E level. Twenty patients who received cardiac surgery were divided into the membrane oxygenator group and the bubble oxygenator group. In each group, five patients received 12,000 units.kg-1 of ulinastatin 15 min after starting CPB. Blood samples were obtained 15 min after starting CPB and 15 min after reperfusion of coronary artery. In the bubble oxygenator group without ulinastatin, vitamin E level at reperfusion phase decreased significantly compared with that at the start of CPB. In the bubble oxygenator group with ulinastatin, vitamin E level at reperfusion phase showed no decrease compared with the level at the start of CPB. In the membrane oxygenator group, there was no significant change in vitamin E level. Therefore, we suspect that a decrease of vitamin E during CPB with bubble oxygenator demonstrates the evidence of free radical generation and these results suggest that ulinastatin may scavenge free radicals during CPB.

Adult↗
PubMed1995

[The effect of nicorandil on the neuromuscular block induced by vecuronium].

The effect of nicorandil on the neuromuscular block induced by vecuronium was investigated in vitro with rat phrenic nerve-hemidiaphragm preparation. Both single twitch (ST) and train-of-four ratio (TOFR) elicited with indirect electrical stimulation were used. The administration of nicorandil alone showed no effects on ST and TOFR. The pre-administration of nicorandil exerted significant depressing effect on ST compared with vecuronium alone. High concentration of nicorandil (4 x 10(-6) M) produced more significant effect on ST compared with low concentration of nicorandil (10(-7) M). In this study, the nicorandil showed similar effect as calcium antagonists on neuromuscular blockade.

Animals↗
PubMed1995

[A case of chronic persistent cough caused by gastro-esophageal reflux].

Although gastro-esophageal reflux (GER) is one of the major causes of chronic persistent cough (CPC) in the USA and in Europe, it is a rare cause of CPC in Japan. We report a rare case of CPC caused by GER, in which treatment with an H2-blocker or with a proton pump inhibitor was successful. A 65-year-old woman had complained of coughing for over 25 years. Her coughing was not alleviated by treatment with a bronchodilator (beta 2-adrenoceptor agonist), an anti-allergic agent, a corticosteroid, or a sedative. GER was considered as a possible cause of her coughing because exacerbation of the coughing was associated with the development of gastrointestinal symptoms (heartburn). Fiberoptic esophagoscopy showed esophagitis and esophageal herniation of the sliding type. Twenty four-hour monitoring of distal esophageal pH showed that the coughing occurred when the pH dropped below 4, and that the pH was less than 4 for about 7% of the whole monitoring time. An H2-blocker or a proton pump inhibitor completely eliminated the symptoms. Therefore, CPC caused by GER was diagnosed. We found that coughing could be induced by instillation of 0.1 N hydrochloric acid at the distal esophagus, and that the coughing was partially inhibited by inhalation of an anti-muscarinic agent (ipratropium bromide) and by esophageal instillation of 4% xylocaine. These data support the "reflex theory". Although CPC caused by GER is rare in Japan, we should remember that GER can be a cause of CPC even in Japanese patients.

Aged↗
PubMed1995

Early recovery of host-derived hematopoiesis in marrow transplant recipients conditioned with high-dose busulfan and cyclophosphamide.

Three marrow transplant recipients with hematologic malignancies (two AML, one myelodysplastic syndrome) experienced prolonged pancytopenia after allogeneic BMT following conditioning with non-TBI regimens containing high-dose busulfan and cyclophosphamide (Bu/CY), despite the use of G-CSF. Early recovery of host-derived hematopoiesis ensued. Although neutrophil counts in these patients exceeded 500 x 10(6)/l by day 30 after transplant, these cells were of host origin. This early recovery of host-derived hematopoiesis has been observed rarely among patients conditioned with TBI-based regimens. When patients conditioned with Bu/CY show delayed hematologic recovery, mixed chimerism should be considered even in the presence of normal neutrophil recovery.

Adolescent↗
PubMed1995

Establishment of a CD4+ T cell clone recognizing autologous hematopoietic progenitor cells from a patient with immune-mediated aplastic anemia.

In some patients with aplastic anemia (AA), hematopoietic function is dependent on continuous administration of cyclosporine A (CyA). These AA patients may have T lymphocytes whose myelosuppressive effect is mitigated by CyA. We established a total of 29 T cell clones from the bone marrow of a CyA-dependent AA patient in relapse. Some of the CD4+ T cell clones demonstrated a specific proliferative response to irradiated autologous bone marrow cells enriched for CD34+ cells (CD34(+)-rich cells) obtained from the patient in remission. One of the T cell clones showing the best proliferative response to CD34(+)-rich cells carried the T cell receptor V beta 17 and produced interferon-gamma (IFN-gamma) only when cultured with autologous CD34(+)-rich cells. This T cell clone inhibited colony formation by colony-forming unit-granulocyte/macrophage (CFU-GM) and burst-forming unit-erythroid (BFU-E) by approximately 60% when it was cultured with autologous CD34(+)-rich cells in methylcellulose medium, although the clone did not exhibit direct cytotoxicity to the CD34(+)-rich cells. The inhibition of in vitro hematopoietic progenitor cell growth by the T cell clone was partially abrogated by the addition of CyA to the culture. These findings suggest that in some patients with CyA-dependent AA, CD4+ T cells autoreactive to hematopoietic progenitor cells exist and may play an important role in the pathogenesis of bone marrow failure.

Adult↗
PubMed1995

[Congenital protein C deficiency with pulmonary infarction].

A 45-year-old man was admitted with left chest pain and hemoptysis. Chest CT on admission showed multiple areas of wedge-shaped consolidation in both lung fields. A perfusion lung scintigram showed bilateral deficits in both lungs, whereas a ventilation scintigram was normal. The serum concentration and the functional activity of protein C were 41% and 42%, respectively. The same results were obtained from studies of the patient's mother and two sons, which indicated that this was a case of congenital protein C deficiency with pulmonary infarction.

Humans↗
PubMed1995

[Idiopathic interstitial pneumonia (type B) with subacute progressively enlarged bullae].

A 70-year-old man with a 10-year history of seal engraving presented with exertional dyspnea and dry coughing. Chest roentgenograms showed an interstitial shadow and bilateral progressively enlarging bullae. Open lung biopsy led to the diagnosis of idiopathic interstitial pneumonia (Type B). The size of bullae usually does not change, so cases such as this are rare because the bullae continued to expand subacutely. Persistent stimulation by the inhaled A1 and Si may have played a role in the pathogenesis of this condition.

Aged↗
PubMed1995

[A case of intra-pulmonary lymph nodes presenting as multiple small nodular lesions in both lungs].

A 59-year-old man came to our hospital for further examination of multiple small nodular lesions in both lungs. Chest CT scan revealed multiple nodular lesions in rt-S6, It-S5, and It-S9 (two lesions). All of these nodules measured about 10 mm or less and those in It-S9 had spicula. Bronchoscopic examination did not yield a definitive diagnosis, so open lung biopsy was done. The open lung biopsy specimen revealed intra-pulmonary lymph nodes with anthracosis and pulmonary emphysema. Intrapulmonary lymph nodes are very difficult to distinguish from small lung tumors by radiographic examination alone, so the possibility that small nodules in the lungs may be intra-pulmonary lymph nodes should be kept in mind.

Chronic Disease↗
PubMed1995

Smaller ports result in shorter convalescence after laparoscopic varicocelectomy.

Minimal postoperative pain and a shorter convalescence after laparoscopic surgery are attributable to the small puncture wounds produced to accommodate trocars. We investigated the effects of trocar size on convalescence after 37 laparoscopic varicocelectomies. The initial 21 patients underwent the procedure with 2, 10 mm. ports and 1, 5 mm. port, while the last 16 underwent surgery with 3, 5 mm. ports. Postoperative convalescence was evaluated by a questionnaire. The patients who underwent the 5 mm. port technique achieved complete pain relief, returned to work and could resume work at preoperative levels significantly earlier than those who underwent the 10 mm. port technique (2.4 +/- 1.5 days versus 5.9 +/- 4.8 days, p < 0.03; 8.2 +/- 3.1 days versus 10.0 +/- 2.5 days, p < 0.03, and 10.2 +/- 4.4 days versus 14.3 +/- 6.5 days, p < 0.03, respectively). Our study showed that laparoscopic surgery with smaller ports resulted in less postoperative pain and a shorter convalescence than when larger 10 mm. ports were used.

Adolescent↗
PubMed1995

[Adenosine deaminase isoenzymes in patients with Graves' disease].

CD26, the T cell activation antigen, is identical to the ADA binding protein and is considered to interact with ADA to activate the T cells on the surface. Therefore, we examined the activity of serum ADA isoenzymes in patients with Graves' disease in whom CD26 presented T cells were increased. The activities of total ADA and ADA2 were significantly higher in Graves' disease than normals. We also observed that the levels of soluble interleukin-2 receptor (sIL-2R) and neopterin, markers of T cell activation, were significantly higher in Graves' disease. The correlation coefficients among ADA2, neopterin, and sIL-2R were significantly high (p < 0.001). Among these parameters, only sIL-2R was correlated with the thyroid hormones. ADA2 activity was considered to reflect the activated state of T cells and to be, independent of the thyroid hormone levels.

Adenosine Deaminase↗
PubMed1995

[A case of renal capsular liposarcoma].

A 53-year-old woman was admitted to the Department of Internal Medicine at our hospital with the primary complaint of pyrexia. Abdominal echography and computed tomography (CT) detected a right renal tumor, and the patient was transferred to our department. Angiography revealed a hypovascular tumor. The main nutrient vessels supplying the tumor were the superior and inferior capsular arteries, which arose from the renal artery. A right renal capsular tumor was suspected from these findings, and radical nephrectomy was performed. Histopathological examination revealed a pleomorphic liposarcoma. Therefore, the patient was given 50 Gy of radiation postoperatively. This is the 14th case of a primary liposarcoma of the renal capsule reported in Japan.

Female↗
PubMed1995

[A case of Rendu-Osler-Weber syndrome and pulmonary arteriovenous fistula].

A 65-year-old man with Rendu-Osler-Weber syndrome was admitted to the department of brain surgery at our hospital because of left hemiplegia and a right cerebral mass seen on a computerized tomogram of the brain. A brain abscess was found during surgery. Then the patient had pneumonia. He received antibiotics and recovered, but his PaO2 remained low. He was transferred to our department for evaluation of hypoxia. Thoracic computerized tomography showed a nodular lesion connected to a vascular shadow. Angiographic examination showed a pulmonary arteriovenous fistula and other vascular abnormalities. He was not dyspneic or cyanotic, but his hypoxia, low diffusing capacity, and brain abscess were thought to be caused by the pulmonary arteriovenous fistula. The fistula was embolized with coils via a percutaneous catheter, after which oxygenation and diffusing capacity improved.

Aged↗
PubMed1995

[Comparison of nerve damage with alcohol and that with phenol in guinea pigs].

We compared the damaging effect on myelinated nerve of alcohol and that of phenol. Guinea pigs of approximately 300 g in weight were used. Right sciatic nerve was exposed after intraperitoneal administration of pentobarbital. Saline was used in the first group as control. The second group received perineural administration of 100% alcohol. The third group received 100% alcohol inside the epineurium. The fourth group received perineural administration of 5% phenol in aqua. The fifth group received 5% phenol in aqua inside the epineurium. The first group showed no change. Toe necrosis was found in 2 cases in the second group, 3 cases in the third, null in the fourth and 6 cases in the fifth group. We concluded that damage was larger with phenol than with alcohol when administered intraneurally, but the difference was not significant. Alcohol administered inside or outside of the epineurium made no significant changes, but phenol administered only inside the epineurium made a significant damage.

Animals↗
PubMed1995

[Pulmonary non-Hodgkin's lymphoma that arose in mucosa-associated lymphoid tissue of the salivary gland and was diagnosed at autopsy].

A 70-year-old woman complained of a dry mouth and swelling in the area of the left parotid gland for 6 years, and was admitted for evaluation of an abnormal shadow on chest X-ray film. She underwent a lip biopsy and a 99mTcO4- scintigram of the salivary gland, and Sjögren's syndrome was diagnosed. Histopathological examination of the percutaneous lung biopsy specimen showed pseudolymphoma, and examination of a specimen of the left parotid gland tumor showed myoepithelial sialadenitis. The patient died of respiratory failure due to a right pleural effusion 4 years later. Autopsy revealed pulmonary non-Hodgkin's lymphoma (diffuse, large, B cell, IgG) with monotonous infiltration of centrocyte-like cells. A retrospectively resected specimen of the left parotid gland tumor showed non-Hodgkin's lymphoma similar to that found in the autopsied lung. This patient probably had pulmonary non-Hodgkin's lymphoma that arose in mucosa-associated lymphoid tissue of the salivary gland and was associated with Sjögren's syndrome.

Aged↗
PubMed1995

Prostanoids and cough response to capsaicin in asthma and chronic bronchitis.

Cyclooxygenase products are released by chronic airway inflammation. Our working hypothesis for the present study was that prostanoids augment airway cough sensitivity. The effects of a cyclooxygenase inhibitor, indomethacin (100 mg.day-1 for 4 days), and a thromboxane synthesis inhibitor, OKY-046 (400 mg.day-1 for 4 days), on cough response to inhaled capsaicin were examined in eight patients with asthma, 10 patients with chronic bronchitis, and 10 normal subjects. Capsaicin cough threshold, the lowest concentration of capsaicin eliciting five or more coughs, was measured as an index of airway cough sensitivity. In asthmatics, the cough thresholds with indomethacin treatment (15.7 (GSEM 1.38) microM) and OKY-046 (10.2 (GSEM 1.20) microM) were significantly greater than the value with placebo (6.05 (GSEM 1.25) microM). In patients with chronic bronchitis, the cough threshold was significantly greater with indomethacin (5.94 (GSEM 1.50) microM) than with placebo (3.41 (GSEM 1.33) microM and OKY-046 2.97 (GSEM 1.43) microM). In normal subjects, the capsaicin cough threshold was not altered by indomethacin or OKY-046 treatment. These results support our hypothesis and suggest that thromboxane A2 may be one of the cyclooxygenase products augmenting airway cough sensitivity in asthma, but not in chronic bronchitis.

Adult↗