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Biomedical subjects

T Matsuda

Publications and source records attributed to T Matsuda.

At least 811 records · Page 45Linked to original sources
PubMed1994

[A case of miliary tuberculosis with high-grade fever that remitted without antituberculosis therapy].

A 23-year-old man was admitted with a persistent high-grade fever of 20 days duration. Chest roentgenogram showed diffuse miliary shadows in both lung fields, highly suggestive of miliary tuberculosis. Sputum, gastric juice, and bronchoalveolar lavage fluid did not, however, reveal acid-fast bacilli on smears. A bone marrow aspirate and a transbronchial lung biopsy were also negative for caseating granulomas and tubercule bacilli. After admission, the high-grade fever remitted in several days without continuous antibiotic, antituberculosis or antipyretic therapy. Levels of inflammatory markers (CRP, ESR, alpha 2-globulin dropped simultaneously. Despite the atypical clinical course, miliary tuberculosis was suspected. We therefore carried out an open lung biopsy. The presence of caseating granulomas and acid-fast bacilli confirmed the diagnosis of miliary tuberculosis. The remission of miliary tuberculosis without treatment is very rare and the details of this case are presented herein with a discussion of the pertinent literature.

Adult↗
PubMed1994

[A case of pneumonitis induced by PL granules].

We report a case of pneumonitis induced by PL granules. A 45-year-old man took PL granules and other drugs for fever and headache. Because he subsequently developed high grade fever, cough and diarrhea, he was admitted to our hospital. His chest X-ray film revealed multiple patchy shadows in both lung fields. Analysis of bronchoalveolar lavage fluid (BALF) disclosed a high number of cells (total), lymphocytes, and a high CD4/CD8 ratio. Microscopic examination of transbronchial lung biopsy (TBLB) specimens showed infiltration of mononuclear cells and thickening of the alveolar wall. After discontinuation of drugs, his condition (symptoms, laboratory data, and chest X-ray findings) promptly improved. Lymphocyte stimulation tests (LST) for PL granules and acetaminophen were positive and an oral challenge test with PL granules was also positive. Based on these findings, we diagnosed this as a case of pneumonitis and enteritis due to PL granules. To our knowledge, this is the first reported case of pneumonitis due to PL granules.

Acetaminophen↗
PubMed1994

Effects of DX-9065a, an orally active, newly synthesized and specific inhibitor of factor Xa, against experimental disseminated intravascular coagulation in rats.

We investigated the protective effects of DX-9065a, an orally active, newly synthesized and specific inhibitor of factor Xa, against two kinds of experimental disseminated intravascular coagulation (DIC) in rats. Endotoxin-induced experimental DIC was induced by a 4-h sustained infusion of endotoxin at a dose of 100 mg/kg. Thromboplastin-induced experimental DIC was induced by a bolus injection of thromboplastin at a dose of 150 mg/kg. The rats were orally administered DX-9065a at 10, 30 or 100 mg/kg 30 min before endotoxin or thromboplastin injection. In both DIC models, DX-9065a showed a protective effect against DIC, at all doses and in all parameters, including fibrin/fibrinogen degradation products (FDP), fibrinogen level, prothrombin time, activated partial thromboplastin time, platelet count and the number of renal glomeruli with fibrin thrombi. When DX-9065a was orally administrated at 100 mg/kg without endotoxin or thromboplastin, no significant changes were seen in hemostatic parameters except PT and APTT, and no fibrin thrombi or abnormal bleeding were seen in renal specimens. These findings suggest that the new oral anti-Xa drug, DX-9065a, has an effect in reducing the severity of DIC. However, further dose-finding and safety studies of this drug have still to be assessed.

Administration, Oral↗
PubMed1994

[A case of vertebral metastasis revealed by incomplete spinal analgesia for cesarean section].

A 36-year-old woman was scheduled for Cesarean section under spinal anesthesia. She was a carrier of hepatitis-B-virus and diabetic. She was complaining of low back pain. Spinal anesthesia was performed in the left lateral decubitus position. Because lumbar puncture in the midline was difficult, left paramedian approach was tried. Then she began to complain of right leg pain. Another attempt was made at other site, but her pain was not relieved. After confirming drop of blood-tinged cerebrospinal fluid, 0.3% dibucaine 2.0 ml was injected. Sensory anesthesia was assessed by pin-prick, but anesthesia was not effective. Then epidural catheter was inserted at Th12-L1 using median approach. She received 1.0% lidocaine 15 ml. However, sensory anesthesia was insufficient (Th4-Th12). Therefore O2-N2O was administered in addition to regional anesthesia. After the delivery, she still complained of low back pain. Later examination revealed metastatic bone tumor of L2 from hepatoma. This case suggests that in a patient with such incomplete spinal or epidural anesthesia and neurological finding, vertebral metastatic tumor should be ruled out.

Adult↗
PubMed1994

[Development of new drugs for intractable vasculitis--lipo-PGE1 and monoclonal antibody].

"Lipo-PGE1", PGE1 incorporated into lipid microspheres (LM), has marked antiplatelet and vasodilatory actions. Since LM largely accumulate in inflamed vascular lesions, lipo-PGE1 shows a marked efficacy for treating vascular diseases such as atherosclerosis and vasculitis. Another recently developed drugs against intractable vasculitis are monoclonal antibodies to surface antigens of lymphocytes. Treatment with humanized anti-CDw52, and subsequent anti-CD4 monoclonal antibodies was reported to have brought remission up to 42 months.

Alprostadil↗
PubMed1994

[Persistent müllerian duct syndrome: report of two cases].

Persistent Mullerian duct syndrome is characterized by the retention of mullerian derivatives in patients otherwise normally virilized. Clinically, the persistence of uterus and tubes leads either to cryptorchidism or inguinal hernia. The condition is usually discovered at surgery. We report two boys with this anomaly. In each case, hysterectomy and orchidopexy were carried out. The gonads were testes and the karyotype was 46, XY. Long-term follow up for these patients is necessary because of an increased risk of testicular tumors and infertility which will develop in future.

Cryptorchidism↗
PubMed1994

[Allergic purpura].

Explore the source record for details and available documents.

Diagnosis, Differential↗
PubMed1994

[Abscess formation in a Rathke's cleft cyst].

A 66-year-old woman with a diagnosis of asymptomatic Rathke's cleft cyst had been observed for almost 2 years and was admitted to our hospital in June 1992 because of high fever and loss of consciousness. Ophthalmological examination revealed right Horner's sign and ophthalmoplegia. A tentative diagnosis of bacterial meningitis was made based on the results of a lumbar puncture. T1-weight MRI showed a marked increase in the size of the suprasellar cystic mass lesion compared to the MRI images obtained 2 years earlier. Hence, the preoperative diagnosis was pituitary abscess. Both transsphenoidal and nasal drainage of the abscess were performed. The pathological findings were consistent with a Rathke's cleft cyst and showed chronic inflammatory cells. The postoperative course was uneventful and the patients eye movements recovered completely. The possible mechanisms of abscess formation in Rathke's cleft cyst are discussed.

Aged↗
PubMed1994

[Spontaneous regression of small cell lung cancer].

An 82-year-old man was admitted for evaluation of dry cough and low grade fever. A chest roentgenogram obtained on admission revealed an abnormal mass shadow at the left hilus. Trans-bronchial lung biopsy was used to make a diagnosis of small cell lung cancer. This tumor regressed spontaneously.

Aged↗
PubMed1994

Plasma levels of lipoprotein(a) are elevated in patients with the antiphospholipid antibody syndrome.

The mechanisms underlying clinical abnormalities associated with the antiphospholipid antibody syndrome (APAS) have not been elucidated. We measured plasma levels of lipoprotein(a) [Lp(a)], the active form of plasminogen activator inhibitor (active PAI), thrombin-antithrombin III complex (TAT) and soluble thrombomodulin (TM), to investigate the relationship of these factors to thrombotic events in APAS. Mean plasma levels of Lp(a), TAT, active PAI and TM were all significantly higher in patients with aPL than in a control group of subjects. Plasma levels of Lp(a) and active PAI were significantly higher in patients with aPL and arterial thromboses than in patients with aPL but only venous thromboses. There was a significant correlation between plasma levels of Lp(a) and active PAI in patients with aPL. These findings suggest that patients with aPL are in hypercoagulable state. High levels of Lp(a) in plasma may impair the fibrinolytic system resulting in thromboses, especially in the arterial system.

Abortion, Habitual↗
PubMed1994

Inhibitory effect of aerosol administration of a sulfidopeptide leukotriene antagonist on bronchoconstriction induced by antigen inhalation in guinea pigs.

The effects of inhalation of the sulfidopeptide leukotriene antagonist AS-35 (9-[(4-Acetyl-3-hydroxy-2-n-propyl-phenoxy)methyl]-3-(1H- tetrazol-5-yl)-4H-pyrido [1,2-a]pyrimidin-4-one, CAS 108427-72-1) on bronchoconstriction induced by aerosol antigen, histamine, and leukotriene C4, D4 (LTC4, D4) were investigated in anesthetized and artificially ventilated guinea pigs. The increase in pressure at the airway opening (P(ao)) was measured as an index representing the grade of bronchial response. The bronchoconstriction induced by aerosol antigen was suppressed dose-dependently by pretreatment with inhaled AS-35 (0.1 mg and 1 mg) through a pressurized meter-dosed inhaler in the passively sensitized animals pretreated with diphenhydramine hydrochloride. But the histamine-induced bronchoconstriction was not altered by the pretreatment with AS-35 inhalation. On the other hand, LTC4- and LTD4-induced bronchoconstriction was inhibited by the pretreatment with aerosol AS-35 in a dose-dependent manner. The deposited dose of inhaled AS-35 in the peripheral airways was 3.5 micrograms and 6.5 micrograms when 0.1 mg and 1 mg of the drug was inhaled, respectively. These results suggest that sulfidopeptide leukotrienes (s-LTs) play an important role in the allergic bronchoconstriction in guinea pigs pretreated with antihistamine, and AS-35 inhalation may be beneficial in the treatment of asthma.

Administration, Inhalation↗
PubMed1994

[A case of diffuse lung disease with bronchiolitis obliterans organizing pneumonia and chronic eosinophilic pneumonia pattern].

A 63-year-old male with a history of cement exposure visited our hospital in August of 1992 with chief complaints of yellow sputum and cough. Chest CT on admission revealed segmental fine nodular shadows in the right lower lobe and a band-like shadow in the left lower lobe. The transbronchial lung biopsy (TBLB) specimen showed alveolitis with a minimal degree of eosinophilic infiltration and organizing exudates in the dilated peripheral air spaces. The open lung biopsy specimens showed, in addition to the TBLB observations, lymphoid hyperplasia, dust deposition, and cystic dilatation of alveolar ducts. After treatment with corticosteroids, but not antibiotics, the abnormal opacities disappeared. This case appears to be characteristic of both bronchiolitis obliterans organizing pneumonia and a chronic eosinophilic pneumonia pattern.

Bronchiolitis Obliterans↗
PubMed1994

[A case of retroperitoneal schwannoma associated with primary hyperparathyroidism].

A rare case of benign retroperitoneal schwannoma in a 47-year-old female is reported. She was initially diagnosed to have an adrenal tumor at the Prefectural Cancer Center Hospital and was subsequently admitted to this hospital. When she was admitted, she was diagnosed as undergoing a hypercalcemic crisis (s-Ca 9.2mEq/l). Serum intact-PTH was elevated, but urine cyclic-AMP and % TRP were almost normal. Gd-DTPA enhanced T1 weighted MRI showed a hyperintensity area between the trachea and the thyroid. A parathyroid tumor and a retroperitoneal tumor were excised completely. The final pathological diagnoses were determined to be a parathyroidal adenoma and a retroperitoneal Schwannoma. After a 6-month follow-up period no recurrence and no electrolytic imbalance were detected and the patient presently displays no further symptoms.

Adenoma↗
PubMed1994

Metastases from carcinoma of the colon and rectum detected in small lymph nodes by the clearing method.

A study of regional lymph node metastases was performed using the clearing method in 322 patients with carcinoma of the colon and rectum (140 with carcinoma of the colon and 182 with carcinoma of the rectum) who had undergone surgical resection. The mean number of nodes examined per patient was 76.4 and the metastatic rate (patients with metastases divided by the total of patients) was 61.4 percent, with a metastatic incidence (nodes with metastases divided by the total of examined nodes) of 6.4 percent for carcinoma of the colon using the clearing method. For carcinoma of the rectum, the mean number of nodes examined was 73.7 with a metastatic rate of 57.1 percent and a metastatic incidence of 7.1 percent. In contrast, node analysis by the conventional manual method resulted in a mean of 18.1 nodes being examined, with a metastatic rate and incidence of 42.1 and 12.8 percent, respectively, for carcinoma of the colon. Manual examination of lymph nodes in carcinoma of the rectum resulted in a mean of 21.2 nodes being examined, with a metastatic rate and incidence of 50.0 and 16.8 percent, respectively. Compared with the manual method, the clearing method provided a greater number of nodes, a higher metastatic rate and a lower metastatic incidence. These differences may be explained by the detection of metastatic regional nodes smaller than 4 millimeters in maximum diameter by the clearing method. By TNM classification there were more pN3 than pN2 lesions. The five year survival rate after curative resection was 78.5 percent for pN1 lesions, 45.7 percent for pN2 lesions and 45.4 percent for pN3 lesions for carcinoma of the colon and 72.7 percent for pN1 lesions, 75.0 percent for pN2 and 53.9 percent for pN3 lesions for carcinoma of the rectum. There was no significant survival difference between the patients with pN1, pN2 and pN3 carcinomas. The presence of regional nodes metastases should be examined in detail. Therapies and prognosis of carcinoma of the colon and rectum should be discussed based on accurate staging.

Colonic Neoplasms↗
PubMed1994

[Symptomatic Rathke's cleft cyst: a clinicopathologic study of 9 cases].

Nine cases of symptomatic Rathke's cleft cyst are reported. Their most frequent signs and symptoms included headache, chiasmal syndrome and hypopituitarism, while one of the cases developed a sudden onset of headache and vomiting following diabetes insipidus. Endocrinological findings showed a decreased ACTH, gonadotropin and growth hormone more frequently while there were 2 cases of hyperprolactinemia and 1 case of diabetes insipidus. In a neuroradiological examination, a plain skull X-ray showed 5 cases of ballooning of the sella turcica, and a CT scan demonstrated a low to high density of the cyst and 2 cases of marginal enhancement of the cyst. MRI mostly demonstrated a well delineated mass at the sella extending mostly into the suprasellar region and a low to high intensity of the cyst in the T1-weighted image. Two cases were marginally enhanced after gadolinium DTPA administration. The pathological examination, done on 6 cases, showed either single or multiple layers of the epithelium which were mostly ciliated. The epithelium was positive in PAS and Alcian blue in all cases and a histochemical examination showed 3 cases to be positive in EMA and 2 cases positive in CEA. A resection of the cyst wall and an opening of the cyst is thus recommended in symptomatic cases. Therefore, the transsphenoidal approach should be the choice of treatment in an intra- and suprasellar extension of the cysts with sellar enlargement.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

[A case report of rounded atelectasis on MRI].

A 73-year-old man was admitted to Toyama Red Cross Hospital, because of productive cough and right flank pain. His chest X-ray film and computed tomography (CT) showed pleural effusion and a mass shadow in the right lung area. On CT vessels and bronchi were seen curving toward the mass (comet tail sign), suggesting rounded atelectasis. Transthoracic lung biopsy under CT and echo guidance revealed suppurative pleuritis. MRI also showed the comet tail sign. Moreover, in the lesion, curling hypointense lines were observed on various slices. We describe how MRI facilitates the diagnosis of rounded atelectasis.

Aged↗
PubMed1994

[Two cases of pulmonary hypertrophic osteoarthropathy associated with primary lung cancer, in which symptoms were rapidly improved by resection of the primary lesions].

Pulmonary hypertrophic osteoarthropathy (PHO) is a syndrome of unknown etiology, presenting with osteitis of the long bones, arthritis, and clubbing of digits, associated with lung cancer or other chronic pulmonary or pleural diseases. Although about 3-10 percent of cases of lung cancer were reported to be associated with PHO in USA or Europe, reports of these cases are relatively rare in Japan. We report two cases of PHO associated with primary lung cancer, in which symptoms were rapidly improved by resection of the primary lesions. Both cases were poorly differentiated adenocarcinoma of the lung (pT2N0M0, Stage I). The bone and joint pain rapidly improved soon after the resection of the primary lesions. The abnormal findings of bone scan and bone X-ray film subsequently improved. In the 2nd case, radionuclide imaging more clearly revealed the presence and extent of subperiosteal activity than radiography. Radionuclide disclosure of PHO was considerably more sensitive than radiography.

Adenocarcinoma↗