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Biomedical subjects

T Murakami

Publications and source records attributed to T Murakami.

At least 667 records · Page 37Linked to original sources
PubMed1997

[Trial of a detachable Y-shaped tube with two valves for serial examinations of CT arterial portography and CT hepatic arteriography].

In five patients with hepatocellular carcinoma, CT arterial portography (CTAP) and CT hepatic arteriography (CTHA) were performed serially by using a newly developed detachable Y-shaped tube with two valves that could be attached to a conventional angiographic sheath. Two catheters could be inserted into the conventional angiographic sheath without blood backflow by using the Y-shaped tube. One catheter could be easily and safety placed on the common or proper hepatic artery, and the other on the superior mesenteric artery. This detachable Y-shaped tube with two valves could make it easy to perform serial CTAP and CTHA examinations.

Angiography↗
PubMed1997

[The surgical results of aged thoracic aortic aneurysm].

Eighty-five patients with thoracic aortic aneurysm (TAA) (36 dissection, 49 non-dissection) underwent surgical intervention in our service from December 1985 to March 1997. 31 patients aged over 70 (aTAA) were compared with 54 patients under 69 years of age (non-aTAA) about preoperative condition, surgical invasion, and operative morbidity and mortality. No significant differences were observed in preoperative associated condition and laboratory data between two groups except more non-dissection were included in aTAA (74.2%) than non-aTAA (48.1%). There were no significant differences in intraoperative variables and endotracheal intubation time and ICU staying time were shorter in aTAA (not significant). No significant differences were revealed in operative morbidity, mortality and five-year actual survival rate between two groups. 16.1% of early mortality and 9.7% of hospital mortality for operated aTAA were acceptable, which let us conclude that aTAA must be operated positively before rupture by careful selection considering life expectancy, evaluation of risk factors or reserved physiological status, and surgical invasion.

Adult↗
PubMed1997

[Surgical results of coronary artery bypass grafting in patients older than 75 years].

We studied 19 patients, all older than 75 years of age, who had isolated coronary artery bypass grafting (CABG) from January 1990 to December 1996. Clinical characteristics, hospital mortality and long-term survival were compared between this elderly group (> or = 75 years) and a younger group (60-74 years) in which 130 consecutive patients underwent the same procedure during the same period. There were no differences of coronary risk factors, renal function, respiratory function and ejection fraction between the two groups. The incidences of left main trunk stenosis (> or = 50%) and three-vessel-disease were more common in the elderly group, but the difference between the groups was not statistically significant. Preoperative use of an intra-aortic balloon pump was more frequent in the elderly group (p < 0.01). The hospital mortality rate of 31.6% for the elderly group was significantly higher than that of 5.4% for the younger group (p < 0.01). However, of particular note is that the 30-day hospital mortality was half (15.8%) and that three of six (50%) hospital deaths occurred between 35 and 148 days. These patients died from acute respiratory failure subsequent to aspiration pneumonia, ruptured dissecting aortic aneurysm, and ischemic enterocolitis. This difference between the 30-day hospital mortality rate (15.8%) and hospital mortality rate (31.6%) emphasizes the influence that postoperative complications can have on subsequent outcome. Of 136 hospital survivors (123 in the younger group and 13 in the elderly), 98% have been followed for a mean of 32 months. The 4-year survival was 60 +/- 22% for hospital survivors of the elderly group. It compares favorably with that for the younger group (85 +/- 5%), and with previously reported data. We conclude that despite a significantly increased hospital mortality, good long-term survival can be realized after CABG, even in patients older than 75 years.

Age Factors↗
PubMed1997

[Exacerbation of atherosclerosis induced by hypertensive and hypercholesterolemic states--potential mechanisms and therapeutic implications].

Several experimental studies suggest many similarities between the effects of hypertension and hypercholesterolemia on the arterial wall. Both hypertension and hypercholesterolemia have proinflammatory effects on the artery. An increased production of oxygen-free radicals leads to increased transcription of redox-sensitive genes, which increases the expression of vascular cell adhesion molecule-1 (VCAM-1) in the endothelium, resulting in increased recruitment of monocytes to the endothelium. The oxidative stress on the arterial wall may occur in both hypertension and hypercholesterolemia, therefore a synergistic reaction between hypertension and hypercholesterolemia may play a role in the atherosclerotic process as common causal mechanisms. Among therapeutic strategies to protect the vascular injury in both hypertensive and hypercholesterolemic state, future research should include direct attack on these common mechanisms.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1997

[A case of papillary adenocarcinoma of the stomach with liver metastases and carcinomatous peritonitis treated effectively by methotrexate/5-fluorouracil sequential chemotherapy].

A 54-year-old male was admitted to receive treatment by anticancer drug for advanced gastric cancer with liver metastases and carcinomatous peritonitis. Upper gastrointestinal series showed a Borrmann type 4 gastric cancer occupying the body and antrum, and a pathological diagnosis of papillary adenocarcinoma was made by endoscopic biopsy. Two cycles of neoadjuvant chemotherapy consisting of 5-FU and low-dose CDDP (FP therapy) were given. No effect was observed, so that the next chemotherapy schedule of sequential MTX/5-FU therapy was performed. We adopted the intermediate (MTX: 100 mg/m2 and 5-FU 600 mg/m2 weekly) dose regimen. When six courses of this regimen were completed, the primary lesion of the stomach was decreased to 60% and the metastatic liver tumor to 72%, basel on criteria for the evaluation of clinical effects of solid cancer chemotherapy. However, pylorous stenosis remained, and we performed gastrojejunostomy and biopsy of the regional lymph node to determine the response to the chemotherapy. A pathological examination of lymph node revealed metastatic papillary adenocarcinoma with xanthogranulomatous change, and was judged as an effect showing grade 2. He was discharged and had the outpatient hospital treatment. He died of exacerbation of carcinomatous peritonitis 10 months after his initial admission. The response duration for sequential MTX/5-FU therapy was 4 months. This therapy was usually effective in patients with poorly differentiated adenocarcinoma of the stomach. Our result indicates that this therapy can be effective for not only poorly differentiated adenocarcinoma but also papillary adenocarcinoma of the stomach in an advanced stage.

Adenocarcinoma, Papillary↗
PubMed1997

The diagnosis and management of splanchnic artery aneurysms. Report of 8 cases.

The purpose of this report is to describe the clinical characteristics and surgical technique for splanchnic artery aneurysms. Over the past 10 years we have surgically resected 8 cases of splanchnic artery aneurysms including 2 cases involving the superior mesenteric artery, 3 involving the renal artery, 1 involving the hepatic artery and 2 involving the splenic artery. Diagnosis was established preoperatively in all patients by splanchnic angiography. Surgical treatment for splanchnic artery aneurysms is indicated in any symptomatic patient, in all symptomatic patients with suspected renal aneurysmal expansion and in patients who have renal aneurysms occurring with functionally important renal stenosis, usually associated with hypertension, in all patients with surgical accessible hepatic artery aneurysms, in all patients who have superior mesenteric artery aneurysms having a high tendency to rupture, and in all patients with an asymptomatic splenic artery aneurysms 1.5 cm or larger in diameter. Although splanchnic artery aneurysms are uncommon and asymptomatic, we recommend that splanchnic arteries should be treated surgically because of their tendency to rupture or organ failure.

Adult↗
PubMed1997

[The change of hepatic energy status after transcatheter arterial embolization (TAE) for hepatocellular carcinoma--a study using 31P-MRS].

In six patients with hepatocellular carcinoma, adenosine triphosphate (ATP) phosphomonoester (PME), phosphoric acid (Pi) and pH were measured before and after transcatheter arterial embolization (TAE), using 31P-magnetic resonance spectroscopy (MRS). The effectiveness of TAE was judged by the extent of lipiodol accumulation within the tumor and change in serum alphafetoprotein level. The pH within the tumor decreased 2-9 days after TAE in all the cases, and beta ATP/Pi ratio decreased when TAE was effective, whereas the ratio did not decrease when TAE was ineffective. The beta ATP/Pi ratio measured by 31P-MRS seems to be a useful, non-invasive marker of the anti-tumor effect of TAE, although further investigation is needed.

Adenosine Triphosphate↗
PubMed1997

[CT guided percutaneous microwave tumor coagulation therapy for local recurrence of rectal cancer].

PURPOSE: To evaluate the usefulness of the CT guided percutaneous microwave tumor coagulation (PMTC) therapy for local recurrence of rectal cancer. MATERIALS AND METHODS: The CT guided PMTC was performed for two patients with local recurrence of rectal cancer. Maximum axial diameter of the tumor was 30 mm on CT images. With patients in the prone position on the CT table, a 14-gauge needle-electrode was used to penetrate the tumor under epidural and local anesthesia. PMTC was performed with an output of 60 watts for 60 seconds at a time. Effects of the PMTC were evaluated by CT images obtained three months after the therapy. RESULTS: In both cases, there was no evidence of tumor growth on the CT images. Clinical symptoms disappeared soon after the therapy, and no major complication was observed. CONCLUSION: The CT guided PMTC therapy was useful for local recurrence of rectal cancer.

Aged↗
PubMed1997

[Brain damage after surgery for thoracic aortic aneurysm].

We analyzed cases with brain damage after surgery for thoracic aortic aneurysm in our institution and investigated the causes, risk-factors and preventive measures for this disastrous postoperative complication. Irreversible brain damage was a complication in 25 out of 184 operative cases (13.6%) over a 21-year period. The cause of brain damage was determined to be embolism by manipulation of the aorta in six cases, clamping of the left subclavian artery in four cases, technical problems of separate cerebral perfusion (SCP) in four cases, severe shock in three cases, embolism unrelated to operative maneuver in three cases, stenosis of a branch of the arch with aortic dissection in two cases, and air embolism, circulatory arrest with insufficient hypothermia and hypoperfusion of a temporary bypass to the left carotid artery in one case each. The neurological symptom improved in eight cases and was unchanged in 17 cases. Eighteen cases died in the hospital. In the univariate analysis, age (p = 0.048), a portion of the aneurysm (p = 0.035), preoperative brain complication (p = 0.003), emergency operation (p = 0.033) and clamping of the arch (p = 0.001) were found to be prominent risk factors for brain damage. In the multivariate analysis, clamping of the arch (p = 0.0310), SCP (p = 0.0327) and emergency operation (p = 0.0223) were prominent. To prevent postoperative brain damage, the arch should not be clamped, appropriate operative techniques to avoid bleeding and to shorten SCP time should be employed, and proper and prompt management of the emergency operation and caution in clamping the left subclavian artery are considered to be necessary.

Adult↗
PubMed1997

[Candida costochondral osteomyelitis, report of a case and review of the literature].

A 49-year-old man was admitted to the hospital with swelling and redness overlying the left anterior chest wall. He had been treated by percutaneous transluminal coronary recanalization for acute myocardial infarction with central venous catheter one year and four months earlier. Since then, he had had no symptoms. An incision and drainage was performed and specimen showed acute and chronic granulation tissue containing pus with involvement of underlying left third rib and cartilage. Candida albicans was cultured from the drainage specimen. Treatment with fluconazole was began. The lesion failed to clear following incision and drainage, continuing to exude pus, then open surgical excision and curettage of the cartilage and rib was performed. After 2 months of therapy, the lesion had resolved. This is a rare case of candida costochondral osteomyelitis without a definite proof of former hematogenous candida infection.

Candidiasis↗
PubMed1997

Case report: non-extraction treatment with functional and mechanical therapy of a Class II division 1 malocclusion.

Non-extraction treatment was carried out for a growing Angle Class II division 1 patient. Because the patient demonstrated potential growth and all the third molars were congenitally missing, the extraction of the four premolars was ruled out. A functional appliance (MGA) and cervical headgear were employed simultaneously in the first phase of treatment. The second phase was carried out by mechanotherapy. As a result, adequate forward growth of the mandible was attained and all 28 teeth were kept in good relation with no root resorption and healthy periodontal tissue. A better improvement of the profile may have been attained had extraction treatment been performed; with non-extraction treatment, however, the amount of tooth movement could be minimized, and root resorption was not observed. The role of the functional appliance is also important for the success of non-extraction treatment in Class II patients.

Cephalometry↗
PubMed1997

Regional cell movement and tissue patterning in the zebrafish embryo revealed by fate mapping with caged fluorescein.

Determination of fate maps and cell lineage tracing have previously been carried out in the zebrafish embryo by following the progeny of individual cells injected with fluorescent dyes. We review the information obtained from these experiments and then present an approach to fate mapping and cell movement tracing, utilizing the activation of caged fluorescein-dextran. This method has several advantages over single-cell injections in that it is rapid, allows cells at all depths in the embryo to be marked, can be used to follow cells starting at any time during development, and allows an appreciation of the movements of cells located in a coherent group at the time of uncaging. We demonstrate that the approach is effective in providing additional and complementary information on prospective mesoderm and brain tissues studied previously. We also present, for the first time, a fate map of placodal tissues including the otic vesicle, lateral line, cranial ganglia, lens, and olfactory epithelium. The prospective placodal cells are oriented at the 50% epiboly stage on the ventral side of the embryo with anterior structures close to the animal pole, and posterior structures nearer to the germ ring.

Animals↗
PubMed1997

Lipoprotein abnormalities in non-insulin dependent diabetic patients with ischemic heart disease.

Plasma lipoproteins and clinical characteristics of non-insulin-dependent diabetic mellitus (NIDDM) patients with (n = 50) and without (n = 108) ischemic heart disease (IHD) were compared. The patients with IHD were older (64 +/- 9 vs 59 +/- 9 years, mean +/- SD, P < 0.01) and had a longer duration of diabetes (14 +/- 9 vs 11 +/- 8 years, P < 0.05). Lipids, lipoproteins and apolipoproteins were comparable in the two groups. The percent distribution of triglycerides (TG) in the very low density lipoprotein (VLDL) fraction was significantly higher (55 +/- 16 vs 50 +/- 17%, P < 0.05). The level of low density lipoprotein (LDL) (33 +/- 14 vs 39 +/- 15%, P < 0.05) and the apo E/VLDL-TG ratio (0.085 +/- 0.045 vs 0.12070.097, P < 0.01), however, was significantly lower in patients with IHD than in those without IHD. Multiple regression analysis also indicated that age, duration of diabetes, percent distribution of TG in VLDL, percent distribution of TG in LDL and the apo E/VLDL-TG ratio were significantly related to the presence of IHD. Hypertriglyceridemia, particularly when characterized by abnormalities of TG distribution, may play an important role in the development of IHD in NIDDM patients.

Aged↗
PubMed1997

Lipoprotein abnormalities in type 2 diabetic patients. Increased distribution of triglycerides (TG) in very low density lipoprotein (VLDL) and decreased apolipoprotein E/VLDL-TG ratio are risk for ischemic heart disease.

Plasma lipoproteins and clinical characteristics of type 2 diabetic patients with (n = 50) and without (n = 108) ischemic heart disease (IHD) were compared. The patients with IHD were older (64 +/- 9 vs 59 +/- 9 years, mean +/- SD, p < 0.01) and had a longer duration of diabetes (14 +/- 9 vs 11 +/- 8 years, p < 0.05). Lipids, lipoproteins and apolipoproteins were comparable in the two groups. The percent distribution of triglycerides (TG) in the very low density lipoprotein (VLDL) fraction was significantly higher (55 +/- 16 vs 50 +/- 17%, p < 0.05). The level of low density lipoprotein (LDL) (33 +/- 14 vs 39 +/- 15%, p < 0.05) and the apo E/VLDL-TG ratio (0.085 +/- 0.045 vs 0.120 +/- 0.097, p < 0.01), however, was significantly lower in patients with IHD than in those without IHD. Multiple regression analysis also indicated that age, duration of diabetes, percent distribution of TG in VLDL, percent distribution of TG in LDL and the apo E/VLDL-TG ratio were significantly related to the presence of IHD. Hypertriglyceridemia, particularly when characterized by abnormalities of TG distribution, may play an important role in the development of IHD in type 2 diabetic patients.

Aged↗
PubMed1996

An anti-HIV peptide, T22, forms a highly active complex with Zn(II).

T22 ([Tyr5,12, Lys7]-polyphemusin II) has been shown to have strong anti-human immunodeficiency virus (HIV) activity, comparable to that of 3'-azide-2', 3'-dideoxythymidine (AZT). T22 takes an antiparallel beta-sheet structure maintained by two disulfide bridges and contains two antiparallel repeats of Cys-Tyr-Arg-Lys-Cys. As reported herein, fully reduced T22 was found by HPLC and ion spray mass spectrometric analyses to form a complex in a molar ratio of 1:1 with Zn(II) ion at neutral pH in aqueous solution. Complexation of Zn(II) ion to this peptide appears to result in tetracoordinate bonding to sulfur atoms of four Cys residues. We also found that the anti-HIV activity of the T22-Zn(II) complex was fourfold stronger than that of T22.

Amino Acid Sequence↗