Biomedical subjects

A Fujiwara

Publications and source records attributed to A Fujiwara.

At least 91 records · Page 5Linked to original sources

PubMed1994

[Bathing a patient with cancer pain treated with continuous epidural blockade--subcutaneous catheter track and Lapack method].

Continuous epidural blockade is considered to be the most useful device for the management of cancer pain. However, it has the disadvantage to compel the patients to restrict their daily activities. We report a unique "Subcutaneous catheter track & Lapack-method" that enabled a patient with epidural catheter to safely bath at home. A 56-year-old male with a local recurrence of rectal cancer was suffering from perineal pain, which was well controlled by oral and epidural morphine. Since his wishing was to bath, we made a long subcutaneous catheter track with Tuohy-needle to prevent infection, and let him bath with transparent film dressings (Bioclusive) and Lapack to tightly cover and seal up the catheter. Although subcutaneous pustule occurred 7 days after the beginning of bathing, it was easily cured by local disinfection. He was able to enjoy bathing without any infection with this method at home for about 2 months after discharge, until he returned to the hospital. "Subcutaneous catheter track & Lapack-method" offers a safe and comfortable bathing to patients with epidural catheter, and contributes to the improvement of their quality of life.

Analgesia, Epidural↗

PubMed1994

[Surgical treatment of coronary artery aneurysm as a complication developed after PTCA].

A 56-year-old man was admitted to our medical center because of acute anterior myocardial infarction. Emergent percutaneous transluminal coronary angioplasty (PTCA) resulted in successful dilatation at the stenotic lesion of the left anterior descending artery (LAD). Three months later, coronary angiography showed not only a restenosis but also an aneurysm formation at the same portion. This lesion was too risky to redo PTCA. We successfully performed coronary bypass grafting with the internal thoracic artery.

Aged↗

PubMed1994

[Repeat open heart surgery using continuous warm blood cardioplegia].

Myocardial protection during repeat open heart surgery still remains to be further improved. The purpose of this study was to evaluate the usefulness of continuous warm blood cardioplegia (CWBC) comparing with intermittent cold GIK cardioplegia (ICGC) in repeat open heart surgery. Twenty-four patients underwent repeat open heart surgery through re-sternotomy (11 mitral, 6 aortic 5 double, 2 congenital) were divided into two groups, that is 10 received CWBC (warm group) and 14 ICGC (Cold group). Spontaneous recovery of heart beat was obtained in 9 of 10 patients (90.0%) in warm group, in contrast only 2 of 14 (14.3%) in cold group (p < 0.001) following aortic declamping. Postoperative peak level of serum CK-MB in warm group (25.9 +/- 7.4 IU/l) was significantly lower than that (83.1 +/- 24.6) in cold group. In warm group left and right ventricular stroke work index significantly increased at 24 hours postoperatively, whereas no significant increase was found in cold group. Postoperative bleeding in the first 24 hours was less (553.8 +/- 38.9 ml) in warm group than that (974.3 +/- 54.1 ml) in cold group. In warm group 3 patients were operated on without homologous blood transfusion, in contrast none in cold group. Our results clearly demonstrated that CWBC was preferable to ICGC for myocardial protection in repeat open heart surgery.

Adolescent↗

PubMed1994

[Myocardial protection during aortic valve replacement: effectiveness of continuous warm blood cardioplegia].

Effectiveness of continuous warm blood cardioplegia (CWBC) during aortic valve replacement (AVR) was studied by comparing with intermittent cold GIK cardioplegia (ICGC) in 32 patients who underwent AVR using CWBC in 16 and ICGC in the other 16 patients. There was no operative nor hospital death in this series. In CWBC group, spontaneous recovery of the heart beat following aortic declamping was seen in 14 of 16 patients (87.5%), in contrast only in 4 of 16 (25%) in ICGC group. During the early postoperative period, left ventricular stroke work index (g.m/beat/m2) significantly increased from 41.0 +/- 14.4 to 55.9 +/- 8.0 (p < 0.001) in CWBC group, whereas no significant increase was found in ICGC group. Right ventricular stroke work index significantly increased only in CWBC group as well. In CWBC group, myocardial oxygen and lactate extraction rates were maintained within normal range during aortic cross-clamping, suggesting satisfactory myocardial preservation with an aerobic metabolism. In conclusion, CWBC is superior to ICGC as a myocardial protection during AVR.

Aortic Valve↗

PubMed1994

[Clinical study on transfer into lung tissue of cefminox].

Nineteen patients who underwent pulmonary resection due to lung diseases were administered with 2 g of cefminox (CMNX) by intravenous drip infusion just before surgery. CMNX levels in the serum and lung tissue were determined and pharmacokinetic parameters were derived. The obtained results are summarized as follows: 1. Pharmacokinetic parameter (K1/K2) derived from serum and lung tissue concentrations using deconvolution method was 0.46. 2. CMNX was useful for prophylaxis of postoperative infections with lung resection.

Adolescent↗

PubMed1993

Left ventricular aneurysm, normal coronary arteries and embolization in a patient with systemic lupus erythematosus.

We describe a 30-year-old woman with a normal appearing coronary artery associated with SLE who suffered myocardial infarction with left ventricular aneurysm and systemic embolization including cerebral infarctions and saddle embolism. The patient was surgically treated with good results. To our knowledge this is the first reported case of systemic embolism due to myocardial infarction occurring in SLE with a normal coronary artery.

Adult↗

PubMed1992

Trigeminal neurinoma presenting with intratumoral hemorrhage: report of two cases.

We report 2 cases of trigeminal neurinoma presenting with spontaneous intratumoral hemorrhage. There are only 2 similar cases reported in the literature. Presenting symptoms were headache, diplopia, disturbed consciousness and trigeminal disturbance with sudden onset. CT scan showed a typical fluid-fluid level within low-density mass in the cerebellopontine angle in one case. On MRI, one case showed a typical fluid-fluid level on T2-weighted image and another one had mixed signal intensities including hyper- and hypointensities on both T1- and T2-weighted images. Histologically, increased vascularity, consisting of dilated and thin-walled vessels presenting telangiectatic or cavernous angiomatous appearances were observed in the specimens in both cases. The size of these tumors was about 3 cm each in diameter. Risk factors for hemorrhage appear to be large tumor size and increased vascularity.

Aged↗

PubMed1992

Enhancing effect of pokeweed mitogen on the proliferation and the cytotoxicity of lymphokine-activated killer cells.

In order to obtain more potent lymphokine-activated killer (LAK) cells for use in adoptive immunotherapy, pokeweed mitogen (PWM) was added to the culture medium for the initial 24-48 h of culturing. The proliferation rate of PWM-stimulated LAK cells reached about 1000-fold after 3-week culture. This rate was nearly the same as that of LAK cells stimulated by 10 ng/ml of OKT3, the mouse anti-CD3 monoclonal antibody. However, the cytotoxicity of PWM-stimulated LAK cells was significantly more potent than that of OKT3-stimulated LAK cells. Phenotypic analysis revealed that PWM-stimulated LAK cells were CD3+CD56(+)-dominant while OKT3-stimulated LAK cells were CD3+CD56(-)-dominant. About half of CD3+CD56+ PWM-stimulated LAK cells was CD8+. These results suggest that more efficient adoptive immunotherapy is possible by using high-dose PWM-stimulated LAK cells with more potent cytotoxicity. Interleukin-1 beta and tumor necrosis factor alpha were significantly increased in the culture media after 24-h incubation with 1 micrograms/ml of PWM. Secretion of interferon-gamma was not enhanced by this concentration of PWM within 24 h. Therefore, PWM is considered to activate monocytes or macrophages to produce these cytokines in advance, influencing the proliferation and the cytotoxicity of LAK cells.

Antigens, CD↗

PubMed1992

[Imprint cytodiagnosis of lymph node metastasis in resected lung cancer].

The cytological examination of lymph node imprints is a rapid and useful method for diagnosis of lymph node metastasis. We applied this technique for the diagnosis of regional lymph node metastasis of resected lung cancer, and compared its diagnostic value with histological examination. The accuracy rate of imprint cytology is 97.3%, and the sensitivity rate is 100%. We conclude that imprint cytology of lymph node for diagnosis of cancer metastasis is highly accurate and simple, and its diagnostic value may be equal to that of routine histological examination.

Adenocarcinoma↗

PubMed1992

[A clinical experience of continuous warm blood cardioplegia in two cases of repeat aortic valve surgery].

The continuous warm blood cardioplegia (CWBC) was used for myocardial protection during aortic cross clamping in two cases of repeat aortic valve operations with good results. Case 1: A 46-year-old man, who underwent an aortic valve replacement because of the rheumatic aortic regurgitation (AR) in 1978, have suffered from orthopnea due to para-prosthetic valvular regurgitation since 1983. He was revealed to have bi-ventricular hypertrophy with myocardial damage on ECG, EF 0.27 on UCG, PCWP 20 mmHg and severe AR on cardiac catheterization. Case 2: A 43-year-old man, who had an aortic valvuloplasty for the non-rheumatic incompetency in 1981, have had a recurrent regurgitation, resulting in left ventricular hypertrophy accompanied by chest pain. Both cases were reoperated upon, having aortic valve replacement with mechanical prosthetic valves through the re-median sternotomy, utilizing CWBC with good recovery. CWBC provides an ideal circumstances for myocardial oxygen utilization during aortic cross clamping and moreover a benefit that needs not the wide dissection of the heart in a redo case because it has no need of topical cooling and ventricular defibrillation following aortic declamping. In conclusion, CWBC is very useful in a repeat aortic valve surgery.

Adult↗

PubMed1992

[Coronary artery bypass grafting in patients with severe left ventricular dysfunction: internal mammary artery vs saphenous vein, evaluation immediately after surgery].

Comparative studies of the changes in left ventricular (LV) function immediately after aortocoronary bypass graftings (CABG) and early postoperative results were carried out in two groups of patients with severe LV dysfunction (ejection fraction less than 0.4), which consisted of 9 patients received internal mammary artery grafts (IMAG) to at least LAD and 14 with saphenous vein grafts (SVG) only. The utilization of IMAG was limited to the patients with stable preoperative hemodynamics, whereas SVGs were used even in the emergency CABG. Free flow of IMAG measured during operation was 55.7 +/- 25.5 ml/min, which was significantly lower than that (83.5 +/- 27.3) of SVG to LAD. Cardiac index, LV stroke volume index and LV stroke work index immediately after surgery were sufficiently maintained and recovered almost similarly in both groups. Postoperative peak CK-MB (19.7 +/- 10.4 IU/L) in IMAG group was significantly lower than that (23.9 +/- 10.7) in SVG group. There was no significant difference between the two groups in the incidences of postoperative IABP and noradrenaline dependence. There were two hospital deaths in SVG group, whereas no hospital death was experienced in IMAG group. These results indicate that an application of IMAG to LAD in the patients with severe LV dysfunction surely induces satisfactory recovery of hemodynamics immediately after CABG as well as SVG, provided that use of IMAG is limited to the patients with stable preoperative hemodynamics.

Aged↗

PubMed1992

[Evaluation of postoperative pulmonary complications and remaining pulmonary arterial flow of lobectomized lung cancer patients using pulmonary digital subtraction angiography].

Postoperative pulmonary complications cause the decrease of the flow of remaining pulmonary circulation. We examined the effects of the difference of resected lobes on the postoperative course and remaining pulmonary circulation of the lobectomized lung cancer patients using a pulmonary digital subtraction angiography. In all cases with preoperative pulmonary complications, circulatory flow of the remaining lung on the operated side significantly decreased. In the cases without preoperative pulmonary complications, only the cases performed left upper lobectomy developed the decrease of the circulatory flow on the operated side. This seemed to be chiefly caused by a postoperative continual atelectasis of the remaining lower lobe due to kinking of the bronchus. On the other hand, the postoperative decrease of the residual pulmonary circulatory flow on the operated side was not developed in the cases undergoing a segmentectomy, even with pulmonary complications. Therefore, for any case requiring a left upper lobectomy or the case with an impaired lung requiring any type of lobectomy, contralateral pulmonary function should be exactly evaluated preoperatively.

Aged↗

PubMed1992

[A resected case of thymolipoma].

We reported a resected case of thymolipoma, which has been hardly experienced. The patient was 21-year-old female and consulted a doctor for general fatigue. Chest roentgenogram revealed a mass-like shadow at the right lower mediastinum, which was suspected mediastinal tumor. The mass of right anteroinferior mediastinum, which was clearly shown by chest CT scan and MRI, was continued to the right lobe of the thymus. Under a diagnosis of anterior mediastinal tumor, operation was carried out. The tumor, which was 10 x 8 x 7 cm in diameter and 160 g in weight, was removed together with right lobe of the thymus. Histological diagnosis of thymolipoma was obtained from the resected specimen.

Adult↗

PubMed1992

[Successfully treated intraoperative coronary artery spasm in a patient with type B dissecting aortic aneurysm: a case report].

A 65-year-old man with chronic type B dissecting aortic aneurysm, complicated by variant from of angina pectoris without any coronary artery obstructed disease on preoperative angiogram was operated upon through left posterolateral thoracotomy under the left heart bypass with Bio-pump system using preoperative Ca antagonists and intraoperative nitroglycerin infusion. Shortly before the end of operation the patient suddenly developed shock status definitely due to coronary artery spasm, associated with ST-elevation in II, III, aVF and bradycardia, then ventricular tachycardia, finally cardiac arrest. The patient was resuscitated by cardiac massage and administration of nifedipine and nitroglycerin. Such attacks repeated five times at ten or twenty minutes intervals. The coronary artery spasm could be successfully suppressed with the additive use of noradrenaline infusion. The patient had no attacks at all postoperatively and was discharged with good success. This case suggests that the prevention of intraoperative coronary artery spasm is essential, but if it occurs, additive use of noradrenaline infusion is effective for the cessation of coronary artery spasm.

Aged↗

PubMed1991

Electrophysiological properties of membrane currents in single myometrial cells isolated from pregnant rats.

The whole-cell voltage-clamp method was applied to single smooth muscle cells prepared from the longitudinal layer of the pregnant rat myometrium (17-20 days of gestation). It was found that the transient inward current mainly consists of Ca2+ current, because the removal of Ca2+ ions from the external medium and 10 microM nifedipine eliminated this inward current. Its steady-state inactivation curve was obtained by the standard method, in which the membrane potential of half inactivation and the slope factor were estimated to be -58.0 +/- 4.9 mV (n = 11) and 8.9 +/- 1.4 mV (n = 11), respectively. In a small number of preparations (in 2 out of 30 preparations), there remained a very fast inward current in Ca(2+)-free medium containing Mg2+. Tetrodotoxin (TTX, 10 microM) can can abolish this current, suggesting that the channel for this current is equivalent to the Na+ channel in nerve cells. Two major phases of outward currents were identified by voltage jumps from negative holding levels to more positive levels. The first phase was a fast transient outward current. This current remained intact after external tetraethylammonium (TEA, 20 mM) was added. Following the transient current, a large delayed rectified outward current reached its peak over a period of 50 ms and then decayed. The reversal potential for this outward current was determined by observing the change of polarity of the tail currents with the change in extracellular K+ concentration [( K+]o). The slope for the change of reversal potential per ten-fold change in [K+]o is 57.7 mV at more than 23.2 mM [K+]o, indicating that this current is mostly carried by K+ ions. Voltage-dependent inactivation of the delayed rectified outward current was determined by the standard method. The membrane potential for half inactivation and the slope factor were estimated to be -42.8 +/- 3.9 mV (n = 3) and 10.1 +/- 1.5 mV (n = 3), respectively. External TEA (20 mM) effectively eliminated the delayed rectified outward currents. Nifedipine (10 microM) suppressed not only Ca2+ current but also outward K+ currents.

Animals↗

PubMed1991

Activating effect of light irradiation at various wavelength on the respiration in sperm of the echiuroid, Urechis unicinctus, in the presence of carbon monoxide.

In sperm of the echiuroid, Urechis unicinctus, respiration in the presence of CO was reversibly augmented by light irradiation in an examined range of wavelengths between 350 and 650 nm. The respiratory rate of sperm in the presence of CO was enhanced by light irradiation in proportion to the light fluence rate. A sharp and large peak was obtained at the wavelength of 430 nm in the action spectrum of photo-activated respiration of sperm in the presence of CO. Broad and small peaks were also found at around 530 and 570 nm. This action spectrum is similar in its profile to the absorption spectrum of reduced cytochrome b. Absorption of photon energy by reduced b-type cytochrome probably activates the redox reaction of this cytochrome to enhance the respiratory rate. Photo-activated respiration in the presence of CO was inhibited by antimycin A and cyanide. In this respiratory system, an electron equivalent is probably transferred through the mitochondrial respiratory chain between cytochrome b and cytochrome c and finally to molecular oxygen in the reaction catalyzed by the CO-insensitive terminal oxidase.

Animals↗

PubMed1991

[In situ hybridization study on the detection of HPV DNA in adenocarcinoma and adenosquamous carcinoma of the uterine cervix].

Human papillomavirus (HPV) types 16 and 18 have been found closely associated with squamous cell carcinoma and related lesions of the uterine cervix. In order to investigate the relationship between HPV and adenocarcinoma and adenosquamous carcinoma of the uterine cervix, formalin-fixed, paraffinembedded tissues prepared from 38 cases consisting of 30 cases of adenocarcinoma and 8 cases of adenosquamous carcinoma were examined for the presence of HPV DNA by in situ hybridization with digoxigenin labeled HPV 6/11, 16, 18 DNA probes. HPV DNA was localized on the nuclei of the cancer cells in adenocarcinoma and adenosquamous carcinoma. HPV DNA was detected in 13 cases (43.3%) of adenocarcinoma and 4 cases (50.0%) of adenosquamous carcinoma, and HPV type 18 DNA was detected in 13 cases (34.2%) of adenocarcinoma and adenosquamous carcinoma. These findings suggest an association between HPV, especially HPV type 18, and adenocarcinoma and adenosquamous carcinoma of the uterine cervix.

Adenocarcinoma↗

PubMed1991

[Arachidonic acid metabolism and effectiveness of aprotinin treatment during cardiopulmonary bypass].

Arachidonic acid metabolism was investigated in 30 open heart cases, utilizing nonpulsatile cardiopulmonary bypass (CPB), consisted of 15 untreated cases (Group I) and 15 cases treated with aprotinin mostly given into CPB circuit during CPB (Group II). In group I, arterial blood concentration of thromboxane B2 (TXB2, stable metabolite of thromboxane A2, pg/ml) significantly increased from 45.9 +/- 40.5 preoperatively to 560.2 +/- 381.5 (p less than 0.01) at 30 minutes of CPB (total bypass) and to 830.5 +/- 591.1 (p less than 0.005) at the end of CPB (partial bypass). TXB2 levels in pulmonary artery (PA) and left atrium (LA) did not significantly increase just before, 5 minutes of CPB as compared with preoperative value. At the end of CPB TXB2 levels in PA (625.0 +/- 186.3) and LA (817.0 +/- 320.0) were significantly higher than preoperative value. However there was no significant difference between PA and LA values. Contrarily in group II TXB2 levels were significantly suppressed as compared with the value at each corresponding time in group I. beta-thromboglobulin levels also changed almost parallel to TXB2 levels in both groups. In conclusion, arachidonic acid metabolic disorders could occur in CPB circuit rather than in pulmonary circulation during CPB. Aprotinin administration into CPB circuit suppressed to some extent the platelet activation.

Adult↗