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Biomedical subjects

H Mizote

Publications and source records attributed to H Mizote.

At least 37 records · Page 2Linked to original sources

Postoperative posterior retinal holes after pars plana vitrectomy for primary retinal detachment.

BACKGROUND: Although retinal breaks occur frequently during vitrectomy, the postoperative occurrence of new retinal holes close to the vascular arcade after vitrectomy for rhegmatogenous retinal detachment rarely has been reported. METHODS: Three patients with rhegmatogenous, retinal detachment were treated by vitrectomy. More than 49 days after vitrectomy, posterior retinal holes with no retinal detachment occurred halfway between the vascular arcade and the chorioretinal scar around the extrusion hole or the primary retinal tear. RESULTS: These new holes were effectively managed with photocoagulation. CONCLUSION: New hole formation could be caused by the technique of the internal drainage, the contraction of the photocoagulation scar, or epiretinal membrane contraction. Another possibility is that new holes occur through two opposite tangential traction contractile forces: one induced by the contraction of the photocoagulation scar, the other caused by the contraction of the premacular cortical vitreous attached to the vascular arcade.

Aged↗

Mass screening for neuroblastoma: quo vadis? A 9-year experience from the Pediatric Oncology Study Group of the Kyushu area in Japan.

Since 1985, a nationwide program of mass screening for neuroblastoma has been available for 6-month-old infants throughout Japan. From 1985 to 1993, the authors studied 285 patients with neuroblastoma among their regional population of 15 million. There was an increase in the total number of patients per year in comparison to the previous 6-year period (1979 to 1984). However, no significant difference was noted in the number of patients older than 1 year or in the incidence of advanced-stage (stages III and IV) unscreened cases. The majority of neuroblastomas in the screened group showed favorable biological factors, even in the advanced stages. However, there was a small group with histologically and/or biologically unfavorable factors; five of 115 had amplified N-myc oncogene, four of 74 showed unfavorable Shimada histological findings, and three of 33 had an unfavorable DNA ploidy pattern. One case from this group with unfavorable factors died of the tumor. 3) Thirty-eight cases were negative at the time of mass screening, but later presented with neuroblastoma. Most of them were diagnosed between 1 and 3 years of age, and 30 of the 38 cases (78.9%) were advanced stage with unfavorable prognostic factors. Thus, the authors conclude that mass screening at 6 months can detect a selected population of infants with neuroblastoma; some of the tumors may represent subclinical masses destined for spontaneous regression. However, some tumors with unfavorable factors have been detected by mass screening before progression and/or dissemination. Infants in this group are considered to benefit most from early diagnosis and treatment.

Adolescent↗

Bilateral choroidal osteomas associated with histiocytosis X.

A 15-year-old Japanese girl complained of decreased visual acuity in the left eye of 1-month duration. Histiocytosis X had been diagnosed when she was 2 years old based on examination of biopsies of skin and cervical lymph nodes and bone marrow aspirations. She had been in complete remission for 7 years. She exhibited the characteristic ophthalmoscopic, ultrasonographic, and radiologic features of bilateral choroidal osteomas.

Bone Marrow↗

Report on the first annual survey of home parenteral nutrition in Japan.

An annual survey of the current national status of home parenteral nutrition (HPN) in Japan was begun in 1991, with a total of 231 registered patients from 142 institutions providing adequate data for evaluation and analysis. HPN was given for an average of 683 +/- 764 days to 93 patients with malignant diseases and 138 with benign disease, including 53 with inflammatory bowel disease and 79 with short bowel syndrome, 107 (46.3%) of whom were successfully rehabilitated. By the end of 1990, 61% of the patients investigated were still on HPN, 7% had already completed HPN, and 26% had died, the deceased accounting for 54% of the patients with malignant diseases and 7% of those with benign diseases. A total of 321 catheters had been used by all 231 patients, the most common being the subcutaneously implanted type, accounting for 33% of all catheters. By the end of 1990, 32% of these 321 catheters were still in place, 18% had been removed on the termination of HPN and 44% had been removed due to complications of total parenteral nutrition, including 20% for catheter fever. Rehospitalization was required in 62% of the patients, the cause being HPN-related in 21% of the total patients. Metabolic complications were experienced by 60% of the patients, but none of these were severe although 6% required hospitalization.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Neuroblastoma in infants aged less than 6 months: is more aggressive treatment necessary? A report from the Pediatric Oncology Study Group of the Kyushu area.

Infants with neuroblastoma are known to have a better prognosis than older children. In Japan in 1985, mass screening for neuroblastoma in infants aged 6 months was introduced. With this policy, there has been an increase in the number of patients seen with neuroblastoma between 6 and 11 months of age. In a previous report the authors described the management and prognosis of infants with disease detected by mass screening, but there is still little information regarding the strategies of management for infants with neuroblastoma aged less than 6 months. The authors analyzed the data regarding 27 patients aged less than 6 months registered in their region (population 15 million) from 1985 to 1992, and compared it with that of the previous 8-year period. In the younger age group, there was a significantly higher rate of advanced disease stages (III and IV). In spite of the variation in treatment related to the choice of individual institutions, infants with stages I, II, and III disease had a good outcome, suggesting that aggressive chemotherapy is not necessary unless poor prognostic factors are present. One patient with stage IV disease died of disseminated disease and one with stage IVs and 22 copies of N-myc oncogene also died of tumor relapse in spite of aggressive chemotherapy. It is therefore concluded that the prognosis in infants with stage IV and IVs neuroblastoma under the age of 6 months is not as good as had previously been believed, and that such patients, therefore, require special consideration.

Antineoplastic Combined Chemotherapy Protocols↗

Retinal detachment with tear in the posterior fundus following ocular contusion.

Two unusual cases of rhegmatogenous retinal detachment following contusion to the eyeball showed retinal tears at the posterior fundus close to the optic disc and the large retinal blood vessels. In both cases, the tears were not detected immediately after the injury due to a coexisting vitreous hemorrhage. Both patients were successfully treated by pars plana vitrectomy, air-fluid exchange, and endolaser photocoagulation. During vitrectomies, an adhesion of the vitreous to the flap or the operculum of the tear was observed, with detachment of the remainder of the posterior vitreous from the retina. Vitrectomy allowed a more complete resolution of posterior tractional forces than scleral buckling, and eliminated the vitreous hemorrhage.

Adult↗

[Glutamine (Gln) supplementation in septic rats].

The objectives of these experiments were to investigate the effect of Gln supplementation on protein metabolism and immune function in septic rats. (Experiment 1): 73 SD female rats were catheterized for TPN into the jugular vein on day 1. On day 4, the rats were randomized into 4 group: 1) control (C)+Standard TPN (STPN), 2) (C)+Gln TPN (GTPN), 3) sepsis (S)+STPN, 4) S+GTPN. Sepsis was induced by injection of 10(10) C. Coli/kg from the TPN catheter. U-14C-leucine or 15N2-Urea was given before sacrifice on day 5. (Experiment 2): 48 SD male rats were randomized into 3 groups, 1) normal control rat (NC), fed as lib. 2) peritonitis (P)+STPN, 3) P+GTPN. On day 1, 34 rats were catheterized and either STPN or GTPN was begun. On day 3, 6 hours after serum cecum ligation and puncture, resuscitation was done. On day 5, rats were sacrificed. The results were as follows: 1) FSR of ileum, proximal colon, distal colon and muscle were augmented by GTPN, 2) Sepsis caused a significant increase of urea production, but GTPN prevented this increase, 3) lymphocyte blastogenation was decreased with sepsis, but GTPN improved this reduction, 4) Phagocytic index was higher with GTPN than STPN. We concluded that Gln supplementation would prevent from leading the patients with severe infection to the multiple organ failure.

Animals↗

[Protein turnover and amino acids metabolism in septic rats].

This study was carried out to elucidate the protein and amino acids metabolism in septic rats, using constant infusion of 1-13C-leucine (4mg/hr), 5-13C-glutamine (2mg/hr), 1,2-13C-leucine (4mg/hr), or U-14C-leucine (2.0uCui/hr). Whole body protein kinetics showed that protein breakdown rate was increased in sepsis, but no change was found on protein synthesis rate (PSR). Intestinal mucosal fractional synthesis rate (FSR) was increased with sepsis. However, sepsis caused significant decrease of muscle FSR. Both leucine and glutamine oxidation rates were significantly increased in sepsis. Fraction of leucine degradation via glutamine was significantly increased in sepsis. We concluded that 1) both leucine and glutamine were utilized as important energy fuels in sepsis, 2) whole body PSR was influenced by the change of PSR in each organ, 3) the pathway from leucine to glutamine was significant in the degradation of leucine.

Amino Acids↗

[The strategy against post-operative infection in the patients with esophageal cancer].

Post-operative infection with esophageal cancer patients was investigated. The subjects were 325 esophageal cancer patients. The most frequent infectious complication after the surgery was pneumonia, followed by anastomosis between the cervical esophagus and plastic stomach tube. The bacteria frequently found in infectious lesions were pseudomonas or staphylococcus. The more severe infection the patients had, the more gram negative bacteria were found. Bacterial examination during operation showed that more than 80% bacteria was gram negative. Since esophageal cancer patients had a low nutritional state, their immune function was impaired and infection was apt to occur post-operatively. Therefore, special nutritional care was indispensible, such as essential fatty acid, BCAA, and glutamine supplementation.

Esophageal Neoplasms↗

Multiple organ failure (MOF) after intestinal operations--a clinical and statistical study of the past 5 years.

Multiple Organ Failure that occurred in 35 cases out of a total of 1498 cases after intestinal surgery were studied by an analysis of the clinical and statistical data from the past 5 years (1984-1988). 1. The incidence of MOF after intestinal surgery was 2.3%. 2. Twenty-eight of MOF resulted from severe infections. 3. The incidence of infection was highest after esophageal operations. 4. Hepatic failure was the most common type of primary organ failure and renal failure was the second most common. 5. The prognosis for MOF was very poor with a survival rate of 8.7%.

Digestive System Surgical Procedures↗

[Surgical infection and its backgrounds].

The backgrounds of surgical infection of esophageal cancer patients are studied for host factors (relation of nutrition and immune response) and parasite factors surgical parts which are easily contaminated, the differences of serum concentration with 3 methods of antibiotics administration, and the relations about the bacteria in mouth and upper esophagus in operation and bacteria which were found in the respiratory system after operation). The results are as follows. The preoperative nutritional support was effective to rapid recovery of cytological immune functions. But in the post-operative infected cases, immunological recovery delayed and they nutritionally needed BCAA, glutamine, and essential fatty acids. For the study of parasite factors, surgical wounds (neck, chest wall, abdominal wall) were more easily contaminated than other parts except digestive tract. Continuous administration of antibiotics, 1g/hr x 4 was most excessive in three methods. The bacteria in the mouth and upper esophagus in operation and those in airway after operation, were not correlated. Furthermore, antibiotics-resistant bacteria which were Pseudomonas, MRSA were found in the airway. These results indicate that nutritional support is important for the host defense system and antibiotics should be administered considering each operative process. And about the postoperative respiratory infection, protection of hospital infection is important.

Bacterial Infections↗