Biomedical subjects

T Sugimoto

Publications and source records attributed to T Sugimoto.

At least 685 records · Page 38Linked to original sources

PubMed1993

Effect of mild hypothermia on uncontrollable intracranial hypertension after severe head injury.

Recent experimental studies have demonstrated that mild hypothermia at about 34 degrees C can be effective in the control of intracranial hypertension. A randomized controlled study of mild hypothermia was carried out in 33 severely head-injured patients. All patients fulfilled the following criteria: 1) persistent intracranial pressure (ICP) greater than 20 mm Hg despite fluid restriction, hyperventilation, and high-dose barbiturate therapy; 2) an ICP lower than the mean arterial blood pressure; and 3) a Glasgow Coma Scale score of 8 or less. The patients were divided into two groups: one received mild hypothermia (16 patients) and one served as a control group (17 patients). Mild hypothermia significantly reduced the ICP and increased the cerebral perfusion pressure. Eight patients (50%) in the hypothermia group and three (18%) in the control group survived (p < 0.05), while five (31%) in the hypothermia group and 12 (71%) in the control group died of uncontrollable intracranial hypertension (p < 0.05). In five patients in the hypothermia group, cerebral blood flow was measured by the hydrogen clearance method and arteriojugular venous oxygen difference was evaluated before and during mild hypothermia. Mild hypothermia significantly decreased the cerebral blood flow, arteriojugular venous oxygen difference, and cerebral metabolic rate of oxygen (p < 0.01). The results of this preliminary investigation suggest that mild hypothermia is a safe and effective method to control traumatic intracranial hypertension and to improve mortality and morbidity rates.

Adult↗

PubMed1993

Serological evidence of Coxiella burnetii infection in wild animals in Japan.

One hundred and thirty-four (26%) of 511 sera from 11 wild animal species in eight prefectures in Japan had antibody titers to Coxiella burnetii by the enzyme-linked immunosorbent assay. High prevalences were observed in Japanese black bears (Ursus thibetanus) (78%), Hokkaido deer (Cervus nippon yesoensis) (69%), Japanese hares (Lepus brachyurus) (63%), Japanese deer (Cervus nippon centralis) (56%), and to some extent in Japanese monkeys (Macaca fuscata) (28%). A low prevalence (13%) was observed in nutrias (Myocastor coypus). Japanese serows (Capricornis crispus), wild rats (Muroides sp.), raccoon dogs (Nyctereutes procyonoides viverrinus), wild pigs (Sus scrofa leucomystax), and masked palm civets (Paguma larvata) had no detectable antibodies to C. burnetii. Thus, six of 11 wild animal species in Japan were exposed to C. burnetii. Based on the high prevalences in some species, they may be a potential source of infection to both domestic animal and human populations.

Animals↗

PubMed1993

Liver infarction produced by dual vessels occlusion due to trauma and TAE: long follow up using CT, US, and MRI.

The cause of liver infarction previously reported [1-4] are mainly due to occlusion of hepatic artery. Herein, we report the case of liver infarction resulted from simultaneous occlusion of hepatic artery and portal vein due to trauma and therapeutic transcatheter arterial embolization (TAE), and we followed up the infarcted lesion with computed tomography (CT), ultra sonography (US) and magnetic resonance imaging (MR imaging) until it disappeared.

Accidental Falls↗

PubMed1993

Surgical treatment of cardiac myxoma and its complications.

A total of 20 patients (15 women, five men) were operated on for cardiac myxoma. Their ages ranged from 17 to 74 (mean 56) years. Myxoma was located in the left atrium in 18 patients and in the right in two. Systemic embolism occurred in eight patients, causing cerebral infarction in three, ischaemia of the extremities in two, occlusion of the external carotid artery with cerebral infarction in one, myocardial infarction in one and pulmonary infarction in one. Five patients with severe congestive heart failure required emergency surgery. All myxomas were removed using cardiopulmonary bypass with excision of the attachment walls. Details are given of additional surgery performed on some of the patients. Two patients died, one from pulmonary insufficiency after emergency surgery and the other from an unrelated problem. The remaining 18 patients showed a good recovery and are doing well with no intracardiac recurrence, although one with cerebral infarction underwent clipping of an aneurysm, which was detected later in the infarcted area.

Adolescent↗

PubMed1993

[Corneal endothelium damage by air bag system].

We have reported in the past a car crash in which the air bag system might have caused driver's corneal endothelial cell loss. To evaluate the corneal endothelial cell loss caused by air bag systems, we performed several air bag impact tests. We found that the corneal endothelial cell loss was greater at a distance of 240 mm than other distances. We also found that the corneal endothelial cell loss caused by the air bag which has bigger inflater and heavier material was significantly greater than that caused by other systems. This study offers basic data to improve the safety of air bag systems.

Air Bags↗

PubMed1993

[Treatment of staghorn calculi by extracorporeal shock wave lithotripsy monotherapy].

We evaluated retrospectively 107 patients with staghorn calculi who underwent extracorporeal shock wave lithotripsy (ESWL) monotherapy from 1985 to 1990. The 107 patients consisted of 65 complete staghorn calculi and 55 partial staghorn calculi. Staghorn calculi required an average of 4.3 treatment sessions. Using a Dornier HM3 lithotriptor, the stone-free rate was 33% in patients with complete staghorn calculi, and 35% in patients with partial calculi. For stone evacuation following ESWL procedure, ureteral stenting, nephrostomy and transurethral lithotripsy were necessary. Four of the 21 patients who underwent ESWL monotherapy and were available for long-term followup showed stone growth, while all of the 10 patients who underwent open surgery during the previous 5 years became stone free. The average period of hospitalization and cost were 38.3 days and 700,000 yen in patients who had received open surgery, and 25.8 and 1,720,000 yen in patients receiving ESWL monotherapy. In conclusion, ESWL monotherapy is useful, and if patients require complete removal of all stone fragments, a percutaneous lithotripsy should be performed following ESWL monotherapy.

Adult↗

PubMed1993

[Aortic arch reconstruction without aortic cross-clamping using separate extracorporeal circulation].

Between March 1991 and October 1992, 21 consecutive patients underwent aortic arch reconstruction without aortic cross-clamping using separate extracorporeal circulation in combination with retrograde blood cardioplegia (Non-clamping selective cerebral perfusion). Twelve patients had true arch aneurysm, 3 had acute aortic dissection and 6 had chronic aortic dissection including 2 redo cases. Cardiopulmonary bypass (CPB) was instituted with an arterial cannula in the femoral artery and 2 cannulae in both vena cavae. When tympanum temperature was lowered to 20 degrees C by central cooling, CBP was stopped temporarily. As soon as the aortic arch was incised longitudinally together with aneurysm, flexible 12 Fr. balloon cannulae were inserted into the three arch arteries via their orifices and selective cerebral perfusion was started. The perfusion flow was kept between 0.3 L/m2/min and 0.35 L/m2/min with the pressure of catheter tip from 30 to 60 mmHg to keep tympanum temperature 18 degrees C. Heart was protected by retrograde continuous cold blood cardioplegia. During arch correction, the descending aorta was occluded by a balloon then abdominal viscera were perfused via a femoral return cannula and rewarming to 25 degrees C was started to prevent visceral organ failure and coagulopathy. The time of separate perfusion ranged 20 to 161 minutes with a mean of 99.9 minutes. Except one patient who died of pneumonia, 20 patient (95.2%) were discharged and doing well. No cerebral complication, myocardial infarction, lung bleeding and coagulopathy occurred. In order to prevent the infarction by debris and to protect vital organs, this method is reliable for aortic arch reconstruction.

Aged↗

PubMed1993

[The mechanism of pleural liquid transudation and absorption following a new hypothesis].

We have put forward a hypothesis that the pleural fluid is filtered at the arterial ends of the pleural blood capillaries and is absorbed mainly at the venous ends, partly at the lymphatic channels, as it is in the other tissues. Then we have calculated the pleural liquid pressure following the Starling equation applying the ordinary value of factors. The result is that the calculated pleural liquid pressure is low enough to expand the lung.

Capillaries↗

PubMed1993

[The surgical management of blunt liver trauma].

One hundred and sixty-six consecutive patients with closed hepatic injury admitted to Osaka University Hospital from 1966 to 1990 were reviewed to evaluate the surgical procedures for injured liver. Of the 166 patients, 37 died within 24 hours of initial management. Thirteen (35%) of the 37 died related to exsanguinating hemorrhage of liver injury. Emergency laparotomy required hepatic resection in all and revealed hepatic vein or retrohepatic caval injuries in 9. Eighty-nine of 129 patients who survived over 24 hours of initial management underwent emergency laparotomy. Twenty-two of the 129 died thereafter. Five (3 underwent lobectomy and 2 simple suture) died of liver injury-related complications. Perihepatic packing was performed in 5 and all except for 2 of brain death were alive. Most complications except for hemobilia were well resolved. CT scan study revealed profoundly radiating injuries closed to spine in 63% and suggested existence of hepatic vein or caval injury. Especially, 20 of 31 CT studies (65%) in conservative management of liver injury showed the same findings with intact capsule. These results support that exsanguinating hemorrhage from deep injury including hepatic vein or vena cava is the most lethal but can be controlled with liver packing in a similar mechanism to liver trauma in conservative management.

Adult↗

PubMed1993

[Immunohistochemical investigation on intraneural localization of herpes simplex virus type 1 in experimental retinitis. 1. Observation of the retina and optic nerve on the injected side].

In order to examine transfer of herpes simplex virus type 1 (HSV-1) in the retina and optic nerve in rats with experimental retinitis, an HSV-1 suspension (Miyama strain, 1 x 10(7) plaque-forming units per ml, 10 microliters) was inoculated into the vitreous body. One to seven days after HSV-1 inoculation, the animals were perfused through the heart with Zamboni's fixative. Fifty-microns-thick cryostat-cut sections through the retina and optic nerve were immunostained for HSV-1 antigen with rabbit anti-HSV-1 antiserum and avidin-biotin-peroxidase complex. Some sections were counterstained with hematoxylin. At an early stage of the postinoculation period, HSV-1 immunoreactivity was first seen in the cytoplasm of Müller cells and then in various cells of the inner nuclear layer. HSV-1 immunoreactivity was extremely dense in the nuclei of these cells, suggesting that HSV-1 replicates in the nuclei and propagates through the cytoplasm to the membrane of cell processes. At a later stage of the postinoculation period, HSV-1 immunoreactivity was seen in some retinal ganglion cells and optic nerve fibers. The labeling of the optic nerve fibers was found even in the optic tract and often accompanied by labeled glial cells adjacent to the nerve fibers.

Animals↗

PubMed1993

[Surgical treatment of coronary artery-pulmonary artery fistula].

We experienced 4 cases of left coronary artery-pulmonary artery fistula. Two cases had small fistulas associated with atherosclerotic coronary lesions, and the other 2 had large fistulas with aneurysmal enlargement. In the former 2 cases, ligation of the fistulas and closure of the opening of fistula into the pulmonary artery through pulmonary arteriotomy were performed together with coronary artery bypass grafting and left ventricular aneurysmectomy. In one of the latter 2 cases, the fistula arising from the anterior descending branch was ligated and the opening of fistula draining into the pulmonary artery was closed through pulmonary arteriotomy. In another case, both openings of the fistula into the anterior descending branch and the pulmonary artery were closed from inside through incision of the dilated fistula. In all 4 cases, operations were performed using cardiopulmonary bypass and retrograde coronary perfusion, which could afford good heart protection even in cases with coronary lesions and coronary steal phenomenon. All cases went an uneventful postoperative course. Postoperative angiograms showed disappearance of the fistulas in 3 cases. In one case, however, residual fistula was found because a fine fistula might be overlooked. In such a case with complicated fistulas with aneurysmal enlargement, fistulas should be examined carefully through incision of the enlarged anomalous vessels. In this paper, diagnosis, operative indication and treatment for coronary artery-pulmonary artery fistula were discussed.

Adult↗

PubMed1993

Morphometric analysis of renal arterioles in subtotally nephrectomized rats.

Renal arteriolar diameters were measured by using vascular casts in the remnant kidneys of subtotally nephrectomized rats. Two weeks after nephrectomy, both afferent and efferent arterioles were dilated, with development of glomerular hypertrophy. Thirteen weeks after nephrectomy, the afferent arteriole was dilated further, while the efferent arterioles became constricted. Glomerular hypertrophy was augmented. At this stage, the systemic pressure was elevated, with development of marked glomerular sclerosis. Throughout the experiment, captopril lowered the systemic pressure, suppressed glomerular hypertrophy, and limited glomerular damage. Both the afferent and efferent arterioles were dilated further. Changes in the arteriolar diameters and the systemic blood pressure suggested that elevated glomerular pressure existed in the remnant kidney and did not exist in the captopril-treated remnant kidney throughout the experiment. Hydralazine and trichloromethiazide therapy lowered the systemic pressure and maintained the arteriolar diameters and glomerular size at normal levels. However, at the late stage, afferent and efferent arterioles were dilated, with development of glomerular hypertrophy and severe glomerular sclerosis. The results suggested that elevated glomerular pressure was involved in development of glomerular sclerosis. However, factors other than hemodynamics should be considered in the pathogenesis of glomerular sclerosis. A direct causal relationship between glomerular hypertrophy and glomerular damage was not shown because captopril ultimately limited glomerular sclerosis despite glomerular hypertrophy at the early stage, and hydralazine and trichloromethiazide therapy did not ultimately ameliorate the glomerular sclerosis despite normal glomerular size at the early stage.

Animals↗

PubMed1993

[Surgical treatment of left atrial myxoma with coronary arterial lesion].

We experienced two patients of left atrial myxoma with coronary arterial lesion. One patient, who was a 52-year-old female, was transferred to our institute with the diagnosis of acute myocardial infarction. The coronary angiogram showed an abrupt 99% stenosis of posterolateral branch of circumflex artery with no atherosclerotic lesion, and the echocardiography revealed a left atrial myxoma disturbing the blood flow across the mitral valve. She was in congestive heart failure with pulmonary hypertension, and underwent an emergency removal of the myxoma under cardiopulmonary bypass. Another patient, who was a 70-year-old male, was admitted to our institute with the chief complaint of chest pain. The coronary angiogram showed an 75% atherosclerotic stenosis of the right coronary artery, and the echocardiography revealed the left atrial myxoma. He received a removal of myxoma and a coronary artery bypass grafting simultaneously. These 2 patients went a good postoperative course and live a lively life with no local recurrence. In this paper, the surgical treatment of left atrial myxoma with coronary arterial lesion was reviewed.

Aged↗

PubMed1993

[A case of dermatomyositis complicated by thrombotic thrombocytopenic purpura (TTP) which responded to combination of gamma globulin and vincristine--clinical analysis on TTP cases in the Japanese literatures].

A rare case of dermatomyositis and thrombotic thrombocytopenic purpura (TTP), which responded dramatically to high-dose gamma globulin and vincristine is presented. A 42-year old man was admitted for evaluation of polymyalgia and skin change of the face and fingers. Findings of muscle biopsy was consistent with the diagnosis of dermatomyositis. During the course of his hospital stay, he had diffuse purpura, hematuria, high fever, and his consciousness became disturbed. The hemoglobin level and the platelet count decreased. Based on microangiopathic hemolytic anemia, thrombocytopenia and neurological abnormality, a clinical diagnosis of TTP was made. Therapy included high-dose gamma globulin, vincristine, corticosteroids and dextran. One week later, his consciousness became clear, hematological findings improved, and prolonged remission has been maintained for more than 19 months at the time of this report. This case suggests that gamma globulin and vincristine are effective in some with TTP cases. Case reports that have appeared in the Japanese literature are summarized and reviewed in terms of treatment.

Adult↗

PubMed1993

[Accordance of the chemosensitivity between clinical specimens and their xenografts in nude mice by SDI test and the value of in vivo chemosensitivity test using nude mice].

We assessed the sensitivity to anticancer drugs by SDI (succinate dehydrogenase inhibition) test with 11 clinical specimens obtained from operated patients. The results were compared with those of xenografted specimen in nude mice, using the adjuvant part of the specimens assayed. Chemosensitivity of clinical specimens against 3 drugs is mitomycin (MMC), adriamycin (ADM) and cisplatin (CDDP), showed a good accordance (73%) with those of xenografted tumors. The drug sensitivity was considered to be one of the features of original tumors and to be well preserved in the xenografts in nude mice. We also studied in vivo experimental chemotherapy on 19 tumor lines in nude mice to compare the chemosensitivity with clinical response to the same chemotherapy observed in each donor patient. A close correlation (83% on responder, 100% on non-responder and the overall predicting accuracy rate were 95%) was shown, suggesting in vivo nude mouse assay having an excellent predictability for clinical results.

Adult↗

PubMed1993

Role for mucous glycoprotein in protecting cultured rat gastric mucosal cells against toxic oxygen metabolites.

The gastric epithelium is exposed to oxygen radicals that are generated within the lumen. Much interest has been focused on the role of mucus in maintaining integrity of the gastric mucosa against oxidants, because gastric mucus may act as a scavenger of oxygen radicals. The aim of this study was to assess the role of mucous glycoprotein in protecting cultured gastric epithelial cells against oxygen radicals. Monolayer cultures of rat gastric mucus-producing cells were studied. Oxygen radicals were generated by hypoxanthine and xanthine oxidase. Cytotoxicity was quantified by measuring chromium 51 release form prelabeled cells. Rate of mucous synthesis was estimated by incorporation of tritiated glucosamine into the cells. The effects of tetraprenyl acetone (a stimulant of mucus production) and N-acetyl-L-cysteine (a mucolytic agent) on oxygen radical-induced damage were determined. Preincubation with tetrapenyl acetone, while stimulating mucous glycoprotein by the cultured cells, caused a dose-dependent reduction of hypoxanthine-xanthine oxidase-induced 51Cr release, reaching maximum protection of the damage by 31% to 50%. In contrast, pretreatment with N-acetyl-L-cysteine potentiated oxygen radical-induced 51Cr release dose dependently. The protective effect of tetraprenyl acetone was significantly abolished by N-acetyl-L-cysteine. Neither tetraprenyl acetone nor N-acetyl-L-cysteine alone under the conditions of this study affected the cellular content of glutathione, which modulates oxygen radical injury to these cells. These results suggest that mucous glycoprotein partially but significantly protects cultured gastric epithelial cells against extracellularly generated oxygen radicals. It seems likely, therefore, that gastric mucus is involved in antioxidant defenses in these cells.

Acetylcysteine↗

PubMed1993

[Surgical treatment for true aneurysm of the deep femoral artery, and a review of literatures in Japan].

A true aneurysm of the deep femoral artery is very rare among peripheral aneurysms because of its anatomical position and characteristics of wall tissue. An early operation is mandatory because it has a tendency to become a large size and to rupture. During the last eight years, we experienced two cases. One ruptured case underwent only resection of aneurysm and another case received an additional reconstruction of deep femoral artery using saphenous vein graft. Both of them are doing well postoperatively. In this paper, a review of 24 cases including these two in Japanese literature was discussed.

Aged↗

PubMed1993

[Medtronic model 6500 temporary myocardial pacing lead: a report of clinical assessment until three weeks after cardiac surgery].

Medtronic model 6500 heart wire as a right ventricular electrode was assessed in 41 postoperative cases. R-wave amplitude, slew rate, peak-to-peak, output, current, and resistance were measured by Medtronic A-V pacing system analyser, model 5311, for three weeks after open heart surgery. These parameter changed until the 7 th postoperative day, but did not change significantly thereafter. Output and current did not exceed beyond 10 V and 20 mA respectively, where there is limitations of usually available pacemaker. No complication was encountered. These results showed that this heart wire was reliably useful even until 3 weeks after open heart surgery.

Adolescent↗