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Biomedical subjects

T Morimoto

Publications and source records attributed to T Morimoto.

At least 289 records · Page 16Linked to original sources
PubMed1996

Rotational obstruction of nondominant vertebral artery and ischemia. Case report.

A 70-year-old man presented with repeated vertebrobasilar insufficiency for 3 years. Four-vessel angiography revealed complete occlusion of the nondominant left vertebral artery on head turning to the right. Three-dimensional computerized tomography angiography demonstrated atlantoaxial joint dislocation when the head was turned to the right, in accordance with simultaneous occlusion of the left vertebral artery caused by stretching of the artery at C1-2. After posterior fixation of C1-2 by a Halifax interlaminar fixation system, the patient had no further episodes. Hemodynamic function associated with nondominant vertebral artery occlusion contributed to the symptoms in this case.

Aged↗
PubMed1996

Gastric remnant carcinoma after partial gastrectomy for benign and malignant gastric lesions.

BACKGROUND: A retrospective study was designed to evaluate the clinicopathologic characteristics and prognosis of gastric stump carcinoma (GSC) after gastrectomy for gastric adenocarcinoma. STUDY DESIGN: A comparison of the clinicopathologic features was made between 12 cases of GSC and 27 cases of remnant carcinoma (RC) following gastrectomy for adenocarcinoma. The various factors influencing survival of both groups of patients were evaluated separately and by multivariate analysis. RESULTS: Gastric stump carcinoma emerges late after initial gastrectomy and has a significant tendency toward lymph node metastasis. No difference was observed between the survival curves for patients with GSC or RC after gastrectomy for malignancy. Serosal invasion was the factor most affecting survival. CONCLUSIONS: Early diagnosis is most important for management of the disease, and only patients with T2 staged GSC according to the Union Internationale Contre le Cancer classification system might benefit from extensive lymphadenectomies.

Adenocarcinoma↗
PubMed1996

Transient ischemia depletes free ubiquitin in the gerbil hippocampal CA1 neurons.

We investigated ubiquitin immunoreactivity in the post-ischemic gerbil hippocampus using a panel of ubiquitin antibodies. Immunostaining for ubiquitin in the hippocampus was strongly dependent on the antibodies used. With rabbit polyclonal antibody U-5379, immunoreactivity disappeared from the hippocampus in the early reperfusion period and reappeared in the dentate granule cells and CA3 pyramidal cells but never in the CA1 pyramidal cells. In contrast, rat monoclonal antibody DF2 and mouse monoclonal antibody MAB1510 showed sustained immunoreactivity in the CA1 during the 48-hour reperfusion period. On the immunoblots of gerbil brain homogenates, three antibodies, U-5379, DF2 and MAB1510, exhibited similar specificities; all three labeled free ubiquitin most strongly. Immunoprecipitation disclosed that, under nondenaturing conditions, U-5379 bound exclusively free ubiquitin, whereas DF2 and MAB1510 had little affinity for free ubiquitin but appeared to have more affinity for conjugated ubiquitin. Immunoabsorption of these antibodies with free ubiquitin confirmed the above result. It is most likely that U-5379 recognized free ubiquitin in the tissue, whereas DF2 and MAB1510 recognized preferentially conjugated ubiquitin. Thus, transient ischemia depletes free ubiquitin but not conjugated ubiquitin in the CA1. This depletion may be caused by impaired conversion from conjugated to free ubiquitin and/or failure of de novo ubiquitin synthesis.

Animals↗
PubMed1996

The prognostic value of preoperative serum levels of CEA and CA19-9 in patients with gastric cancer.

OBJECTIVES: The clinical significance of preoperative serum levels of tumor markers CEA and CA19-9 was evaluated in gastric cancer patients. METHODS: Serum levels of CEA and CA19-9 were measured in 663 patients with gastric cancer who underwent laparotomies over a recent 4-yr period (1990-1993). The correlations between the serum levels of tumor markers and several clinicopathological factors were evaluated by univariate analysis. The significance of the tumor markers as prognostic factors was assessed by multivariate analysis. RESULTS: The positivity rates of CEA and CA19-9 were 16.6% and 16.0%, respectively. The positivity of CEA correlated well with the sex of the patients, hepatic, peritoneal, and nodal metastases and the depths of tumors, but it correlated weakly with a tumor's histological type. The positivity of CA19-9 correlated well with various forms of metastases, depths, and tumor size. A significant in prognosis was observed between patients positive and negative for CA19-9 among those undergoing R0 resection. Multivariate analysis also revealed that serum CA19-9 was better than CEA as a prognostic factor. CONCLUSIONS: CA19-9 in the preoperative sera is a good prognostic factor in gastric cancer patients, although tumor markers continue to have only limited diagnostic usefulness.

Biomarkers, Tumor↗
PubMed1996

[Clinical significance of urinary free dopamine as a marker of renal function].

Urinary free dopamine (DA) is derived from DA synthesized or converted from circulating DOPA in renal proximal tubules, and plays an important role for diuresis and natriuresis. As plasma free DA is in tiny amounts near detectable range, a large amount of free DA in urine is tubular origin, but not from circulating DA. In the present study, we hypothesized that urinary free dopamine (U-f-DA) can be used as the marker of renal function. We speculated that U-f-DA may decrease in the damage of renal tubules or renal disorder. To evaluate clinical significance of U-f-DA, we used serum creatinine levels as the index of renal function. As the urinary parameter of renal function, we measured U-f-DA, alpha(1)-microglobulin (U-alpha(1) MG), beta(2)-microglobulin (U-beta(2)MG) and N-acetyl-beta-D-glucosaminidase (U-NAG) in spot urine samples of 154 outpatients (male; 76, female; 78). Each values are rectified by creatinine (Cr) concentration in urine. U-f-DA was negatively correlated with the serum level of creatinine, U-alpha(1)MG and U-beta(2)MG. The receiver operating characteristic (ROC) curve analysis was used for their comparison in evaluation of urinary marker of renal function. In this analysis, area under the curve (AUC) of U-f-DA is best among other markers of renal function. AUC of U-f-DA/Cr, U-alpha(1)MG/Cr, U-beta(2)MG/Cr, U-NAG/Cr were 0.82, 0.57, 0.72, 0.62 in male, 0.92, 0.72, 0.81, 0.57 in female, respectively. These results suggest that the measurement of U-f-DA is superior marker of renal function to the determination of U-alpha(1)MG, U-beta(2)MG and U-NAG.

Adult↗
PubMed1996

[Effectiveness of combination hormonal therapies in advanced or recurrent breast cancer--a randomized trial of tamoxifen (TAM), medroxyprogesterone acetate (MPA), their simultaneous combination, and an alternating sequential combination of TAM plus MPA].

The effects of tamoxifen (TAM), medroxyprogesterone acetate (MPA), their simultaneous combination or an alternating sequential combination of TAM plus MPA (TAM-MPA), was evaluated in 52 patients with advanced or recurrent breast cancer in a randomized controlled trial. The response rates of TAM, MPA, TAM & MPA, and TAM-MPA were 13.3%, 36.4%, 7.1% and 25.0%, respectively. All four therapies showed a higher response rate in the patients with soft tissues or with no previous therapy. However, there were no significant differences between the patient's characteristics and response rate among these four therapies. The differences in the frequency of adverse effects among these therapies were not significant, and there were no severe adverse effects with any therapy. In the cross-over trial of TAM and MPA, although 15.4% of patients who failed to show a response to TAM showed an objective response to MPA, no response to TAM was seen in the patients who had failed to show a response to MPA. In conclusion, TAM & MPA was not more effective than TAM or MPA, and TAM-MPA was not more effective than MPA. Adverse effects were not increased with TAM & MPA or TAM-MPA. MPA was useful as a second-line therapy after TAM.

Aged↗
PubMed1996

[Posterior fossa dural arteriovenous fistula with progressive disorder of cerebellar circulation; case report].

A rare case of posterior fossa dural arteriovenous fistula with cerebellar circulation disorder is reported. A 64-year-old male was admitted to a hospital with complaints of nausea, vertigo and mild headache. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed cerebellar infarction. Then, he was sent to our hospital. He had complaints of cerebellar signs and nystagmus. Cerebral angiography showed dural AVF of the posterior fossa and occlusion of the left transverse-sigmoid sinuses. Because his condition deteriorated, embolization of the left middle meningeal artery, ascending pharyngeal artery and occipital artery was performed selectively on August 18. Subsequently, isolation of dural AVF was performed on August 19. After the operation he improved and was able to walk with a stick. Controlled angiography revealed the disappearance of dural AVF. This case suggested that AV shunt is essential for the progression of venous infarction.

Arteriovenous Fistula↗
PubMed1996

[Surgical treatment of active infective endocarditis].

Between August 1980 and December 1995, 29 patients have undergone valve replacement for active infective endocarditis (IE) at our institute. Twenty five patients had native valve endocarditis (NVE) and 4 had prosthetic valve endocarditis (PVE). The indication for surgery in 29 patients was congestive heart failure, septicemia or systemic embolization. Twenty six patients had vegetation. Eleven patients had AVRs, including one modified Bentall operation, 10 had MVRs and four had DVRs with mechanical prosthetic valve. There were eleven early death (38%) and one late death. Operative mortality rate has reduced to 24% after 1991. We conclude that early surgical intervention should be taken according to the hemodynamic state of the patients irrespective of the presence of septicemia.

Adolescent↗
PubMed1996

Successful transplantation of cadaver hearts harvested one hour after hypoxic cardiac arrest.

BACKGROUND: A shortage of donor organs in clinical transplantation prompted us to study whether resuscitated "dead" hearts could be used for successful orthotopic heart transplantation. METHODS: Donor hearts were resuscitated with cardiopulmonary bypass after 3 minutes (the control group; n = 8) or 60 minutes (the experimental group; n = 6) of hypoxic cardiac arrest after induction of brain death. RESULTS: All the animals of each group were successfully weaned from cardiopulmonary bypass with 5 micrograms/kg/min of dopamine 1 hour after transplantation, and cardiac function with or without dopamine was better preserved in the experimental group than the control group (with maximum slope of pressure-volume relationship with dopamine: 198.0% +/- 36.8% versus 121.2% +/- 47.2%; maximum slope of pressure-volume relationship without dopamine: 130.6% +/- 41.5% versus 70.8% +/- 21.5% [mean +/- standard deviation] as percentage of values after brain death, respectively; p < 0.01 by unpaired t test). CONCLUSIONS: These results indicate that cadaver hearts 60 minutes after anoxic arrest can be successfully reanimated and orthotopically engrafted with various methods and drugs.

Animals↗
PubMed1996

Successful engraftment of allogeneic CD34-enriched marrow cell transplantation from HLA-mismatched parental donors.

The CD34 antigen is expressed on pluripotent stem cells and the CD34+ cell has been shown to be capable of hematopoietic reconstitution in animal and human autologous grafts. We asked if CD34+ cells could reconstitute hematopoiesis in human allogeneic transplantation from a HLA-mismatched donor. Three pediatric patients with advanced leukemia received allogeneic CD34-enriched marrow cell graft from HLA two (two patients) or three (one patient) loci-mismatched parental donors. CD34+ cell selection was performed with mouse anti-CD34 antibody 9C5 and magnetic beads coated sheep anti-mouse IgG1. 1.53 to 2.48 x 10(9) marrow cells were processed and 2.53 to 7.89 x 10(7) positively selected cells were recovered. The selected population showed 93.7 to 99.0% CD34+ cells and total recovery of CD34+ cells from the starting population was 54.6 to 62.3%. CD34+ cell selection resulted in more than 99.9% depletion of CD5+ cells from the bone marrow. The patients received 2.53 to 7.25 x 10(6) CD34-enriched cells/kg after myeloablative therapy. All patients achieved trilineage engraftment that was confirmed by various genetic markers. Acute graft-versus-host disease (GVHD) was grade 0 (two patients) or grade I (one patient), and hematological recovery was successfully achieved as follows; the days to reach granulocytes over 0.5 x 10(9)/I were 11 to 13 days, reticulocytes over 2% was 18 to 28 days, platelets over 50 x 10(9)/I was 33 to 58 days. One patient is surviving without relapse of leukemia and two patients died after either mixed hematopoietic chimerism or leukemia relapse was observed. These studies suggest that CD34+ marrow cells are capable of hematopoietic reconstitution from HLA two or three loci-mismatched donors even with the lowest dose of mature T cells.

Adult↗
PubMed1996

Visualization of routes of lymphatic drainage of the gallbladder with a carbon particle suspension.

BACKGROUND: Although carcinoma of the gallbladder frequently spreads lymphatically, few reports exist about the evaluation of routes of lymphatic drainage of the gallbladder by vital staining. The purpose of this study was to visualize drainage routes and the extent of lymphatic flow from the gallbladder by using vital staining with a carbon particle suspension (CH40). STUDY DESIGN: In 20 patients, 0.3 to 0.5 mL of carbon particle suspension was injected into first station nodes for the gallbladder, the cystic node or pericholedochal node, intraoperatively. After a Kocher maneuver was performed, lymph nodes and lymphatic vessels blackened by the stain were visualized macroscopically. RESULTS: Lymphatic pathways from the gallbladder were classified into three routes: right, left, and hilar. The right route, which ran along the common bile duct to the superior retropancreaticoduodenal node or the retroportal node and reached the para-aortic nodes, was stained in 95 percent of patients. The left route, which traveled toward lymph nodes medial to the hepatoduodenal ligament through the posterior aspect of the head of the pancreas, was stained in less than 50 percent of patients. Among lymph nodes along the left route, the posterior common hepatic node was most frequently stained (45 percent). The hilar route, which ascended toward the hepatic hilus, was stained in 20 percent of patients. CONCLUSIONS: These data demonstrate that the right route is a main pathway of lymphatic drainage from the gallbladder, while the left and hilar routes are branch lines. The para-aortic nodes, regarded as final regional nodes for the gallbladder, should be removed during radical surgery for advanced carcinoma of the gallbladder. Drainage along the hilar route may cause metastasis to the liver.

Carbon↗
PubMed1996

[The effect of Shakuyaku-kanzo-to on prostaglandin production in human uterine myometrium].

Shakuyaku-kanzo-to (SK), a Chinese herb medicine consisting of Shakuyaku (Paeoniae Radix) and Kanzo (Glycyrrhizae Radix) has been used for the treatment of dysmenorrhea. It is reported that prostaglandin (PG) production increased during menstruation in uterine myometrium. To know the effect of SK on PG production in the uterine myometrium, the following in vitro study was undertaken. Human uterine myometrium was obtained from patients who underwent hysterectomy. 1. Myometrial cells were cultured and, SK, Shakuyaku (S), Kanzo (K), or glycyrrhetinic acid (GA), which is the major component of K, were added to the culture medium. Concentrations of PGE2, PGF2 alpha, and 6-ketoPGF1 alpha in the medium measured by RIA were significantly decreased by the addition of SK, K or GA but no effect was observed when S. 2. [3H]-arachidonic acid (AA) was added to culture medium and incorporated into the Sn-2 of phospholipids. [3H]-AA release and PG production in the medium were determined. PG were extracted and the radioactivity of PG was measured. The production of PGE2, PGE2 alpha and 6-ketoPGF1 alpha from labeled cells was significantly reduced by the addition of SK, K and GA. 3. Phosphatidylcholine containing [14C]-AA in Sn-2 (150,000 dpm) was incubated with cytosol of uterine myometrium and the amounts of [14C]-AA released were calculated as Phospholipase A2 activity. The amount of [14C]-AA release was inhibited dose-dependently by SK, K and GA. It is the first time that SK has been shown to suppress PG production in the myometrium by inhibiting cPLA2 activity.

Arachidonic Acid↗
PubMed1996

[Clinical significance of plasma free and conjugated dopamine and urinary excretion of free and conjugated dopamine in patients with renal transplantation].

Although free and conjugated dopamine (DA) constitutes most of plasma and urine catecholamine pool, the diagnostic significance of DA estimation for the evaluation of illness is not clear. Plasma free DA is mainly derived from the peripheral sympathetic nerve terminals and the released DA is converted to conjugated DA and to DA metabolites. The free DA concentration in plasma is trace in amount. Urinary free DA is mainly derived from renal tubular cells, and urinary conjugated DA is derived from filtrated DA at glomerulus. We investigated clinical significance of plasma free and conjugated DA and urinary excretion of free and conjugated DA in patients with chronic renal failure before and after renal transplantation. Marked elevation of plasma conjugated DA in patients with renal failure disappeared after hemodialysis or transplantation, like clinical picture of creatinine and blood urea nitrogen. Increases of urinary excretion of free and conjugated DA and of urinary volume were augmented in these patients after renal transplantation. The augmented excretion of urinary free DA resulted from the transplanted renal tubules, which indicate the functional fixation of transplanted kidneys into host patients. These results suggest that the estimations of plasma conjugated DA and urinary excretion of free DA are an important index for the evaluation of renal transplantation and renal function.

Adult↗