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Biomedical subjects

H Akamatsu

Publications and source records attributed to H Akamatsu.

At least 127 records · Page 7Linked to original sources

A case of Dandy-Walker malformation associated with occipital meningocele, microphthalmia, and cleft palate.

We present a case of Dandy-Walker malformation associated with occipital meningocele, microphthalmia, and cleft palate. Small numbers of cases of Dandy-Walker malformation with occipital meningocele have been described in the literature, but to our knowledge, non of these also had microphthalmia or cleft palate. This association suggests that time of intrauterine origin of Dandy-Walker syndrome was in the sixth or seventh embryonic week. In the diagnosis, both CT cisternography and direct neurosonography over the occipital meningocele was useful for the demonstration of a posterior fossa cyst which communicated with the fourth ventricle and the occipital meningocele.

Abnormalities, Multiple↗

Cerebral blood flow velocities in the anterior cerebral arteries and basilar artery in hydrocephalus before and after treatment.

We studied Pourcelot's index (PI), which shows cerebral vascular resistance, in the anterior cerebral arteries and basilar artery, and the PI ratio (Pourcelot's index in the anterior cerebral artery/Pourcelot's index in the basilar artery) in 11 measurements of hydrocephalus. The mean values of PI in the anterior cerebral artery, basilar artery, and the PI ratio before treatment were significantly higher than those after treatment and those in normal infants. Before treatment, the mean PI in the anterior cerebral arteries was significantly higher than the mean PI in the basilar artery. All PI ratios increased to 1.00 or more. After treatment and in normal infants, the mean PI in the anterior cerebral arteries was significantly lower than the mean PI in the basilar artery. All PI ratios decreased to less than 1.00. We believe that the PI ratio is useful to evaluate the need or effect of treatment in hydrocephalus.

Basilar Artery↗

Suppressive effects of linoleic acid on neutrophil oxygen metabolism and phagocytosis.

On the basis of recent reports that the proportion of linoleic acid (C18:2Cis 9,12), a free fatty acid, is markedly decreased in acne comedones and that tetracycline is effective against acne comedones by acting directly as an antioxidant on infiltrating neutrophils, we investigated the effect of linoleic acid on several inflammatory parameters of neutrophils, including neutrophil chemotaxis, phagocytosis, and generation of reactive oxygen species (ROS). Linoleic acid significantly decreased phagocytosis and the generation of O2-, H2O2, and OH.by neutrophils, whereas it did not significantly inhibit neutrophil chemotaxis or decrease the ROS levels generated in a cell-free, xanthine-xanthine oxidase system. The present study seems to suggest that decreased levels of linoleic acid in acne comedones contribute, in part, to the worsening of acne inflammation by the failure of low levels of linoleic acid to suppress neutrophil phagocytosis and ROS generation.

Acne Vulgaris↗

[A case of extended myocardial infarction treated with the left ventricular assist device (LVAD) before and after the operation--the value and limitation of LVAD].

A left ventricular assist device (LVAD) was applied to a patient who had profound left ventricular failure following extended myocardial infarction caused by the left main trunk obstruction. The patient was a 61-year-old man, who had severe chest distress and was admitted 11 hours after the onset of the symptom. At the time of admission, he was already in cardiogenic shock. The emergent coronary angiography showed complete obstruction of the left main trunk and the intact right coronary artery which had no collateral flow to the left coronary artery. The intraaortic balloon pumping (IABP) was started bu could not maintain the satisfied circulation. Then a LVAD was applied to the patient 5 days after the onset. The LVAD maintained the normal circulation and prohibited exaspiration of organ failure. 19 days after the onset, scartectomy and A-C bypass to LAD was performed. The patient could not be weaned from LVAD and died of right ventricular failure following ventricular arrhythmia 20 days after the installation of LVAD. The use of LVAD for nonoperative cardiogenic shock is rare. Circulatory support with a LVAD in the treatment of a patient in cardiogenic shock following a acute myocardial infarction was considered useful.

Coronary Artery Bypass↗

[Measurement of blood flow of saphenous vein graft with Doppler catheter].

We investigated the measurement of blood flow of saphenous vein graft by Doppler Catheter. Under operation of femoro-popliteal bypass graftings (3 cases with 5 grafts of arteriosclerosis obliterans) with reversed saphenous vein grafts, blood flow of saphenous vein graft was measured. At the same time, blood flow of saphenous vein graft was measured by electromagnetic flowmeter. And the values obtained by Doppler Catheter (y) and those obtained by electromagnetic flowmeter (x) were compared. As a result, a good corelationship (y = 0.752 x -14.9, r = 0.836, p = 0, n = 20) was obtained. In conclusion, we suggest that the values of saphenous vein graft can be measured by Doppler Catheter. We actually measured the blood flow of saphenous vein graft with CABG. The measurement was thought to be possible.

Arteriosclerosis Obliterans↗

[Hepatic arterial infusion chemotherapy using totally implantable reservoir in liver metastases in colorectal cancer].

Hepatic arterial infusion chemotherapy using totally implantable reservoir was performed for the treatment of liver metastases of colo-rectal cancers, and the therapeutic effects, side effects and complications were evaluated. Reservoir catheters were implanted into hepatic artery via gastroduodenal artery during operation. Mitomycin C (MMC), adriamycin (ADM), and 5-fluorouracil (5-FU) were used as chemotherapeutic agents. Eleven cases of H1 (metastases in one lobe only), 7 cases of H2 (a few scattered metastases in both lobes) and 12 cases of H3 (multiple metastases in both lobes) were treated intermittently with one-shot administration of MMC or ADM (A-group). Ten cases (H1: 1, H2: 2, H3: 7) were treated with intermittent one-shot administration of MMC or ADM following two-week continuous infusion of 5-FU through infusion pump after operation (B-group). In 5 of 10 cases of B-group, serum CEA level fell below the preoperative level, and the tumor size regressed in 3 of those 5 cases which were evaluated on the basis of CT scan. But no remarkable change in CEA level or tumor size on CT scan was seen in A-group. No particular side effect such as leucopenia, liver dysfunction or gastroduodenal symptom was noted except one case developing multiple gastric ulcers and pancreatitis in B-group. Five cases (25%) showed obstruction of catheter and 3 cases (14%) evidence leakage of chemotherapeutic agents in A-group. Three cases (30%) in agents in A-group. Three cases (30%) in B-group displayed obstruction of gastroduodenal artery beyond the tip of catheter. Median survival time of both groups (A, B) was 6 months and 12 months, respectively. The treatment seemed effective for the improvement of serum CEA level and tumor size, and there was a tendency toward prolongation of survival time in B-group.

Adult↗

Ultrastructural study on the pulmonary parenchyma of the neonates following prolonged mechanical ventilation.

The ultrastructural alterations in the pulmonary parenchyma were studied in four premature babies with the respiratory distress syndrome who were treated by prolonged mechanical ventilation from 43 to 172 days. Macrophages and fibroblasts passed through a defect of the epithelial basement membrane to encompass the hyaline membrane. Thickening and reduplication of epithelial and capillary basement membrane, varying patterns of epithelial regeneration, i.e., hyperplasia of type II pneumocytes and cuboidal cells, and proliferation of fibroblasts and myofibroblasts were observed in the alveolar walls. In the emphysematous areas, elastic fibers were condensed and thickened, or fragmented. All these changes were more pronounced in premature babies, who underwent concentrations of more than 80% of oxygen and high positive end-expiratory pressures (greater than 30 cm H2O) for long periods.

Bronchopulmonary Dysplasia↗

Pedoscope studies on neonatal activity and center of gravity after delivery.

Seventeen normal term infants delivered at the Jikei University School of Medicine were placed daily on a pedoscope in the supine and prone position after birth, and the movement of the gravity center and changes in the activities of the extremities were assessed. The results indicated that both the activity of the extremities and the movement of the gravity center were sluggish after birth, that both increased to reach peaks within 1 to 3 days, and that then temporary decreases occurred before they increased again. The probable reason for the temporary decrease in activity may be habituation or a decrement in the infant, and it is also presumed that the increase in activity after the transitory decrease reflects natural development.

Extremities↗

Glycine cleavage system in ketotic hyperglycinemia: a reduction of H-protein activity.

Glycine cleavage activity was compared in the livers from three cases of ketotic hyperglycinemia (two cases of propionic acidemia and one case of methylmalonic acidemia) and three controls. In one case of propionic acidemia, glycine cleavage activity (5.2 nmole/mg protein/hr) was normal in the liver obtained at biopsy when the patient was well controlled by the treatment with low protein diet (0.8 g/kg/day) and the level of serum glycine was lowered to normal. In the two other cases of ketotic hyperglycinemia, glycine cleavage activity was significantly reduced in the liver obtained at autopsy when the patients died in the state of metabolic acidosis. Its activity in the liver of one case of propionic acidemia (0.7 nmole/mg protein/hr) was 6-26% of that in controls (2.7-10.8 nmole/mg protein/hr), and 2-7% in the case of methylmalonic acidemia (0.2 nmole/mg protein/hr). Analysing of the individual components of the glycine cleavage system, a marked decrease in the activity of H-protein was revealed in the livers of the both patients; it (0.2 nmole/mg protein/hr) was only 3-4% of that in controls (4.9-6.3 nmole/mg Protein/hr). These findings suggest that the reduction of the glycine cleavage system in the liver of ketotic hyperglycinemia occurs secondarily as speculated previously and is caused mainly by a decrease of H-protein activity.

Acidosis↗