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Biomedical subjects

H Shimabukuro

Publications and source records attributed to H Shimabukuro.

At least 19 recordsLinked to original sources

[The anesthetic management for adrenalectomy of a patient with Cushing's syndrome in pregnancy].

The anesthetic management for left adrenalectomy of a pregnant patient with Cushing's syndrome caused by adrenal adenoma during pregnancy was reported. At 21 week gestation, anesthesia was induced with modified NLA and maintained with nitrous oxide-enflurane-oxygen combined with continuous lumbar epidural anesthesia. Postoperatively, she was delivered a normal, 1990 g infant at 37 week gestation. The present case is believed to be the first reported case of general anesthesia in detail for adrenalectomy in a patient with Cushing's syndrome during pregnancy. The anesthetic management including choice of anesthetics, anesthetic method, intraoperative monitoring, influence of catecholamine, and fetal as well as maternal complication was reviewed from literatures.

Adenoma

[Consideration of simultaneous combination chemotherapy--employing a sensitivity test in Dunn osteosarcoma and NR fibrosarcoma by intra-test tube contact of tumor cell suspension, and subcutaneous inoculation].

Fundamental concepts of combination multi-drug chemotherapy have not been well recognized from the aspects of chemo-sensitivity test upon malignant tumors. A chemo-sensitivity test by in-vitro bioassay for Dunn osteosarcoma and NR fibrosarcoma was developed by us to study the simultaneous interactions between two anticancerous agents. 0.1 ml of cell suspension of either mouse sarcoma was immersed in 0.4 ml of RPMI 1640 cell culture medium containing an anticancerous agent such as Mitomycin (MC), Cyclophosphamide (CPM), Vincristine (VC), Bleomycin (BM), 5-FU, Adriamycin (ADM), Cisplatin (CDDP) or Methotrexate (MTX) in a test-tube, and incubated at 37 degrees C for 3 or 6 hours. Then, the sedimented cell suspension of 0.1 ml was inoculated subcutaneously in the dorsum of C3H mouse which provided 4 sites for 4 different sensitivity tests. In 3 weeks, sensitivities of the anticancerous agents were evaluated as positive sensitivity if no growth of the tumor was observed, or negative sensitivity if the growth of more than 10 mm in diameter was observed. Then, the determination of antitumorous effect on 2-drug combination out of the 8 anticancerous agents, were performed on each mouse sarcoma by the same method. In Dunn osteosarcoma or NR fibrosarcoma, the combination of 2 sensitivity-positive agents revealed no apparent synergistic effects. In any combinations of one sensitivity-positive agent with the other sensitivity-negative agent, except the combinations with CPM which possessed mighty antitumorous effect, apparent reduction of antitumorous effects was observed. The combination of 2 sensitivity-negative agents never produced any antitumorous effects.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals

Nationwide survey of HTLV-I-associated myelopathy in Japan: association with blood transfusion.

To study the epidemiology of human T-cell lymphotropic virus type I (HTLV-I)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) in Japan, we conducted two nationwide surveys between October 1986 and March 1989. A total of 710 patients with HAM (definite HAM, 589; probable HAM, 121) were reported. Of the 589 patients with definite HAM, 69% were residents of the areas with the highest prevalence HTLV-I in Japan. To determine the importance of blood transfusion in the pathogenesis of HAM/TSP, we performed a case-control study in the Kagoshima district in southern Japan. Significantly more patients with HAM reported a history of blood transfusion (26/129, or 20%) than did subjects in a health survey of the general population (41/1,290, or 3%; odds ratio = 7.7, p less than 0.001) or than did hospitalized neurological patients (6/119, or 5%; odds ratio = 4.8, p less than 0.001). Furthermore, the cumulative percentages of the intervals between blood transfusion and the onset of the symptoms of HAM fit a lognormal curve, suggesting that transfusion was an important common exposure. Blood transfusion probably transmitted HTLV-I to the patients with transfusion-associated HAM because there was a significant decrease in the number of patients with the transfusion-associated HAM who received blood after implementation of nationwide screening of blood donors in 1986 (p = 0.004). In the first 2 years, screening the blood supply in Japan appears to have decreased the number of reported patients with HAM by 16%.

Humans

[Studies on the giardiasis as the zoonosis].

To obtain basic data on the route of Giardia infection as zoonosis, we examined feces from 80 dogs and 16 cats for Giardia cysts and evaluated the detection rates. In addition, familial infection was studied in 3 family members of the patient with giardiasis. Giardia cysts were detected in 10 of the 80 dogs (12.5%) but none of the cats. Of the 10 dogs from which Giardia cysts were isolated, 6 had been maintained by the breeders. Tow other dogs were for examination in the research institutions. None of the family members of the patient with giardiasis had this infection. Since the detection rates of Giardia cysts in the dogs and cats were low, the possibility that human infection is acquired from dogs or cats seemed to be low. However, some of patients with giardiasis we encountered had never been abroad. This fact together with the presence of Giardia cysts in the dogs despite the low detection rates suggest that attention should be paid to the possible association between human giardiasis and pets since the number of people keeping pets is increasing.

Animals

Chondrosarcoma of the posterior fossa--case report.

The authors describe a case of well differentiated (grade I) chondrosarcoma in a 52-year-old male. The tumor originated in the posteromedial wall of the left petrous bone and extended into the posterior fossa and cervical spine. He showed impaired functions of the left VII to XII cranial nerves. Plain skull x-rays demonstrated erosion of the left petrous and occipital bones, with speckled calcifications. Computed tomography showed a huge mass of slightly high density with mushroom-like calcifications, which was poorly enhanced by contrast medium. Inversion recovery magnetic resonance imaging clearly defined the low-intensity lesion, while the long spin-echo image depicted the tumor as mixed-intensity. On electron microscopic examination, the tumor cells were rich in Golgi apparatus, endoplasmic reticulum, glycogen granules and mitochondria in the cytoplasm, and formed many vacuoles crossing the cell membrane. These vacuoles were suggested to play an important role in matrix formation. Thirty nine other reported cases of chondrosarcoma are reviewed, and the two reported posterior fossa chondrosarcomas are compared with that of ours.

Chondrosarcoma

["One-knot" microvascular anastomosis using glutide as an external splint--experimental arterio-arterial anastomosis in rats].

Experimental microvascular anastomosis using a glutide copolymer (lactide: glycolide = 80: 20) as an external splint was undertaken in rats between the left and the right carotid arteries. Both arteries were dissected free over a 1-cm length, the left carotid artery was transected at the cranial end, and the right carotid artery was cut at the caudal end. The left carotid artery was then introduced into a glutide pipe-splint. The arterial wall was turned back 180 degrees over the edge of the splint. The reflected part of the artery and the glutide were covered with the freed-up right carotid artery. One stitch was made around the two arteries and the glutide in a manner similar to that of binding a barrel with steel wire. The "One-knot anastomosis" was then complete. We call this type of anastomosis "antegrade anastomosis". If, on the other hand, the right carotid artery is introduced into the pipe, turned back at the edge of the glutide, covered with the left carotid artery and secured with one stitch, the technique is known as "retrograde anastomosis". The patency rates of the resulting vessels were as follows: antegrade anastomosis, 83% (15/18); and retrograde anastomosis, 92% (23/25); so that the average patency rate was 88% (38/43). We measured the anastomosing time that is the time between the transection of one of the two arteries and the completion of the anastomosis. The average anastomosing time was 21 minutes for antegrade anastomosis and 14 minutes for retrograde anastomosis. But the 'pure anastomosing time' (the time taken to connect the two already prepared arteries) was 2-3 minutes. We believe that one-knot anastomosis technique for future clinical application is promising.

Anastomosis, Surgical

One-knot microvascular anastomosis. An experimental study in rats.

Experimental microvascular anastomosis using a glutide copolymer (lactide:glycolide, 80:20) as an external splint was undertaken in 33 rats between the carotid artery and the jugular vein. Both vessels were dissected free over a 1-cm length and cut at the cranial end of the dissected part. The carotid artery was then introduced into a glutide pipe-splint. The arterial wall was turned 180 degrees over the edge of the splint. This reflected artery wall and the glutide were covered by the freed-up jugular vein. One stitch was made around the vein, the artery, and the glutide in a manner similar to binding steel wire over a barrel. Thus, the "one-knot anastomosis" was completed. The patency rate at the anastomosed site was 100%, confirmed by angiography in 30 rats and by direct surgery in three. The time required to produce the anastomosis was between 5 and 7 minutes. Light microscopic observation showed that there was no obstruction by thrombus formation at 1 and 5 weeks after the anastomotic surgery. This technique may be clinically applicable for extracranial-intracranial bypass surgery, reconstruction of venous sinuses, and other vascular procedures.

Animals

Chronic encapsulated hematomas in the brain.

Two cases, one of a chronic encapsulated intracerebral hematoma occurring in a 43-year-old man and the other of an intracerebellar hematoma in an 8-year-old boy, are reported. In both cases CT scans revealed an encapsulated lesion containing the hematoma, but angiographic pictures were poor except for revealing a space-occupying lesion and a small vascular lesion. Both hematomas were successfully removed. Each case was associated with a thick, fibrous capsule that was found histologically to arise from an occult angiomatous malformation. The encapsulated hematomas partially included old thromboses, and both old and recent areas of hemorrhage. The latter were considered to be due to the rupture of vessels developed near the inner surface of the thickest part of the fibrous capsule. Although the condition is uncommon, chronic hematoma must be considered when encapsulated mass lesion is present in the brain.

Adult

Spasmodic head movements produced by destruction of unilateral ventromedial tegmentum in cats.

In cats, unilateral electrolytic destruction in the dorsomedial parts of the ventral tegmental area (VTA) (Tsai) led to the appearance of torticollic rotatory head postures associated with a marked drop of the corresponding caudate serotonin. Results obtained from fluorescence histochemistry and brain dialysis also revealed that decrease in serotonin shared the leading role. However, since a chemical lesion produced by neurotoxic agents failed to induce such abnormal postures, concomitant interruption of nonaminergic fibers at VMT might also be the essential factor. Among them the interstitial nucleus (Cajal) and its descending tract were the most suspicious.

Animals

[Marked effect of furosemide and hypertonic saline in the treatment of SIAD after head injury].

A case of SIADH after head injury was encountered and treated successfully with furosemide and hypertonic saline. 250 mg of furosemide was given twice at two hours' interval. The dose of 2.5% saline for the infusion was calculated according to the excretion of sodium in the urine collected during this period. The level of serum sodium quickly rose from 113 mEq/l to 137 mEq/l in 33 hours. The consciousness of the patient returned to normal. The problems of quick correction of hyponatremia including the central pontine neurolysis were discussed.

Adult