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Biomedical subjects

Hisashi Matsumoto

Publications and source records attributed to Hisashi Matsumoto.

At least 19 recordsLinked to original sources
PubMed2006

Use of an air ambulance system improves time to treatment of patients with acute myocardial infarction.

OBJECTIVE: The aim of this study was to clarify whether a helicopter ambulance system (doctor helicopter system; DHS) could shorten the time interval to coronary intervention in the treatment of patients with acute myocardial infarction (AMI), in comparison with ground ambulance (GA). METHODS: The time from the emergency call to coronary angiography (CAG time) or to percutaneous coronary intervention (PCI time), and the inhospital outcome were evaluated in 76 AMI patients. Twenty patients were transported by DHS, and the other 56 were by GA. RESULTS: Both CAG time and PCI time were significantly shorter in the DHS (98.8+/-29.2 min, and 169.6+/-57.4 min) than those of the GA (126.6+/-48.7 min, and 203.2+/-57.0 min; p<0.05) group. Inhospital mortality was lower in the DHS (5.0%) versus the GA (10.7%) group. CONCLUSION: Use of DHS shortened the time interval to coronary intervention and also improved the inhospital prognosis of AMI patients.

Aged↗
PubMed2006

[Survey of PCB and organochlorine pesticide residues in meats and processed meat products collected in Osaka, Japan].

Residues of PCB and organochlorine pesticides in meats (beef, pork and poultry) and processed meat products collected in Osaka, Japan were surveyed. For 35 years from 1970 to 2004, the concentrations of PCB, HCH isomers, DDT analogues and dieldrin in all meats appeared to decline with each passing year. The concentration of each isomer of HCH in all meats declined rapidly from the early to the late 1970's and showed a gentle decline thereafter; beta-HCH showed the highest residue rate of the isomers in all the time periods surveyed, except for pork and poultry samples in the early 1980's. The concentrations of DDT analogues in all meats also showed sharp declines from the late 1970's to the early 1980's, followed by a smaller decrease thereafter; the main residues were pp'-DDD, p,p'-DDE and p,p'-DDT, and the residue rate of p,p'-DDE increased over the years. The residue levels of organochlorine pesticides in processed meat products (raw materials: beef, pork, poultry and mixture of ground beef and pork) were surveyed for 15 years (from 1990 to 2004) and there were no significant differences in the values among the materials. The concentrations of each pesticide in processed meat products tended to be lower than those of the corresponding meat samples, respectively.

Animals↗
PubMed2006

Effectiveness of a "doctor-helicopter" system in Japan.

BACKGROUND: In Japan, helicopters have rarely been used for emergency medical services. The use of helicopters not only ensures rapid evacuation but may also serve to provide emergency management to patients with life-threatening injuries in the prehospital setting. OBJECTIVES: To evaluate a Japanese helicopter-based emergency medical system including an onboard physician, particularly in terms of probability of survival. METHODS: We conducted a retrospective review of trauma victims, and calculated two estimates of PS--at the scene and on arrival at the emergency department--based on patient age, Injury Severity Score, and Revised Trauma Score. RESULTS: We identified trauma victims who had an ISS above 15 and were transported from the scene by helicopter. Excluding cardiopulmonary arrest at the scene, 151 cases were studied. Thirty-two patients had hemodynamic instability with systolic blood pressures below 90 mmHg, caused by hemorrhagic shock (29 cases) or obstructive shock (3 cases). Their PS values were 0.56 +/- 0.38 in the prehospital setting and 0.65 +/- 0.38 on arrival at the ED, representing a significant difference (P = 0.0003). Twenty-four of these patients survived, reflecting successful resuscitation during prehospital and ED management. CONCLUSIONS: A doctor-helicopter system was shown to improve probability of survival for life-threatening trauma in the Japanese emergency medical system.

Adolescent↗
PubMed2005

[Estrogenic activity of ultraviolet absorbers and the related compounds].

The estrogenic activities of ultraviolet absorbers and their related compounds were investigated using MCF-7 cell proliferation assay. Nine of 33 chemicals (benzophenone, 2,4-dihydroxybenzophenone, 2,2',4,4'-tetrahydroxybenzophenone, 2-hydroxy-4-methoxybenzophenone, 2,2'-dihydroxy-4,4'-dimethoxybenzophenone, 4-hydroxybenzophenone, 3-(4-methylbenzylidene) camphor, ethyl 2-cyano-3,3-diphenylacrylate (etocrylene) and 2-ethylhexyl-2-cyano-3,3-diphenylacrylate (octocrylene)) were positive compared with the vehicle control. Benzhydrol, ethyl cinnamate and 2,2'-dihydroxy-4-methoxybenzophenone were weakly active. When each xenoestrogen was added to the cells along with ICI 182780, an estrogen receptor (ER) antagonist, the cell growth was reduced according to its doses. Therefore, the cell proliferation was suggested to generate through ER. Most of these chemicals were also positive using CHOOSER assay, a new method of testing estrogenic activity of xenoestrogen. Each xenoestrogen was also confirmed to bind to ERalpha and ERbeta using a human ER competitive binding assay against 17beta-estradiol. The concentration order of the strength of its inhibitory effect using both ERalpha and ERbeta was similar to that of MCF-7 cell proliferation assay, except for benzyl 4-hydroxybenzoate (B4HB). B4HB showed a stronger activity on CHOOSER assay and the competitive binding assay using both ERalpha and ERbeta, although there was no activity observed on MCF-7 cell proliferation assay. Our findings were to detect the estrogenic activity of etocrylene and octocrylene in vitro, in addition to confirming the activities of some ultraviolet absorbers as previously reported.

Alkaline Phosphatase↗
PubMed2005

[Congener-specific analysis of Pcbs in food samples by using GC/MS].

A GC/MS method for congener-specific analysis of polychlorinated biphenyls (PCBs) in food samples was evaluated. There was good agreement between total concentration of PCBs in fish samples (n = 16) measured by using the GC/MS method and the conventional GC-ECD method. The total diet study samples (fishery food, meat, egg, milk, and their products) collected from Osaka in 1982-2001 were analyzed by using the GC/MS method to estimate the temporal trend of daily intake of PCBs from food. The estimated daily intake of total PCBs (sum of tri- to heptaCBs) was in the range of 0.7-4.4 microg/person/day, far below the Japanese provisional acceptable daily intake (250 microg/50 kg-person/day). The dominant congener was 2,2',4,4',5,5'-hexachlorobiphenyl (#153), which accounted for 9-15% of total PCB. The ratio of lower chlorinated congeners decreased from the 1980's to post-2000. The results indicate that the PCB congener profile in foods has gradually changed.

Food Analysis↗
PubMed2004

Early access to patients with life-threatening cardiovascular disease by an air ambulance service.

The purpose of this study was to determine whether use of an air ambulance service using a helicopter with a critical care physician and nurse on board (doctor helicopter service; DHS) could shorten the prehospital delay. We evaluated the initial treatment time and the transport time in 30 patients transported by DHS and 30 patients transported by ground ambulance service (GAS). The initial treatment time was significantly shorter in the DHS group (11.3+/-5.4 min) than in the GAS group (29.5+/-15.3 min). But the transport time in the DHS group (26.1+/-8.6 min) was not different from that in the GAS group. The difference in the initial treatment time was remarkable for patients transported from distant areas (12.7+/-5.6 min for DHS, and 42.1+/-13.8 min for GAS) and DHS shortened the initial treatment time by 30 min compared with GAS. The transport time was shorter for DHS (30.5+/-9.9 min) than for GAS (42.1+/-13.8 min) for patients transported from distant areas, but it was not significantly different for patients transported from nearby areas (22.3+/-5.0 min for DHS, and 18.4+/-2.4 min for GAS). In conclusion, DHS is important in the management of life-threatening cardiovascular diseases, and has a significant impact when GAS cannot transport a patient to the hospital within 20 min.

Aged↗
PubMed2003

[Clinical pathway for inpatients with gastric ulcer: evaluation of usefulness].

Based on the results of a retrospective review of clinical data on inpatients with gastric ulcer treated at our department, we devised on original clinical pathway and tested it in the clinical setting. From the results obtained, we created an improved clinical pathway and evaluated its usefulness. The duration of hospitalization was 16.2 +/- 6.9 (mean +/- SD) days in the non-path group, 14.1 +/- 3.0 days in the original path group, and 10.9 +/- 2.0 days in the improved path group. The hospital time was significantly shorter in the improved path group. For patients with bleeding gastric ulcer, the duration of hospitalization was 18.0 +/- 6.3 days in the non-path group, 15.1 +/- 2.3 days in the original path group, and 11.2 +/- 1.8 days in the improved path group. This period was also significantly shorter in the improved path group. With regard to the occurrence of rebleeding from the gastric ulcers, there were no significant differences between the non-path group and both clinical path groups. These results indicate that devising a clinical pathway is useful for shortening the duration of hospitalization for patients with gastric ulcer.

Critical Pathways↗
PubMed2002

[Damage control for thoracic injuries].

A critically injured chest trauma patient showing profound shock or cardiac arrest en route to the trauma center or in the emergency room sometimes requires emergency room thoracotomy and definitive repair. In some patients damage control must be performed because of the appearance of the deadly triad of hypothermia, acidosis, and coagulopathy. Indications for damage control are believed to be body temperature < 34 degrees C, pH < 7.2, and clinically uncontrollable bleeding. The strategy for damage control consists of three steps: step 1, rapid control of hemorrhaging and abbreviated surgery in the ER or OR; step 2, correction of hypothermia, acidosis, and coagulopathy and reevaluation of the injuries in the intensive care unit; and step 3, definitive surgery in the OR. Damage control procedures for chest injuries include aortic cross-clamping, hilar clamping, major vessel ligation, pulmonary tractotomy, simultaneously stapled pneumonectomy or lobectomy, cardiac stapling, balloon catheter tamponade, temporary intraluminal shunt, towel packing, towel clip closure, single en masse closure of the chest wall, etc. Every surgeon responsible for treating critical chest trauma patients should have knowledge of damage control and also be familiar with the techniques.

Acidosis↗
PubMed1999

Increased prevalence of intestinal inflammation in patients with liver cirrhosis.

AIM:To investigate the pathophysiology of the digestive tract in patients with liver cirrhosis.METHODS:In 42 cirrhotic patients and 20 control subjects, the following fecal proteins were measured by enzyme-linked immunosorbent assay: albumin (Alb), transferrin (Tf), and alpha(1)antitrypsin (alpha(1)-AT) as a marker for intestinal protein loss, hemoglobin (Hb) for bleeding, PMN-elastase for intestinal inflammation, and secretory IgA for intestinal immunity.RESULTS:The fecal concentrations of Hb, Alb, Tf,alpha(1)-AT, and PMN-elastase were increased in 13 (31%), 8(19%), 10(24%), 6(14%), and 11 (26%) cases among 42 patients, respectively. Fecal concentration of secretory IgA was decreased in 7 (17%) of 42 patients. However, these fecal concentrations were not related to the severity or etiology of liver cirrhosis. The serum Alb level was significantly decreased in patients with intestinal protein loss compared to that in patients without intestinal protein loss.CONCLUSION:These findings suggest that: (1)besides the well-known pathological conditions, such as bleeding and protein loss, intestinal inflammation and decreased intestinal immunity are found in cirrhotic patients; (2)intestinal protein loss contributes to hypoalbuminemia in cirrhotic patients, and (3) intestinal inflammation should not be over looked in cirrhotic patients, since it may contribute to or cause intestinal protein loss and other various pathological conditions.

Journal Article↗
PubMedDate not supplied

Effect of direct hemoperfusion with a polymyxin B immobilized fiber column on high mobility group box-1 (HMGB-1) in severe septic shock: report of a case.

Because of the many difficult aspects in the treatment of septic shock and poor outcome of this condition, establishing the most appropriate therapeutic strategy is problematic. Recently, high mobility group box-1 (HMGB-1) has been shown to activate inflammatory responses and to be a late mediator in endotoxemia and sepsis. Therefore, we considered that it might be worthwhile to investigate the therapeutic potential of HMGB-1 blockade in cases of septic shock.Herein, we describe the case of a patient with septic shock with hepatic portal venous gas caused by intestinal obstruction. Hepatic portal venous gas is a rare condition associated with significant radiographic findings and a fatal outcome. Our patient, however, recovered from severe septic shock and was saved by the use of direct hemoperfusion with a polymyxin B immobilized fiber column (DHP-PMX). This treatment resulted in a decrease in the serum levels of endotoxin, interleukin-6 (IL-6), and HMGB-1.

Aged, 80 and over↗
PubMedDate not supplied

Xanthogranulomatous cholecystitis mimicking stage IV gallbladder cancer.

Patients with xanthogranulomatous cholecystitis often undergo excessive surgical resections because of difficulty in distinguishing their condition from gallbladder cancer. Herein we present a patient with xanthogranulomatous cholecystitis mimicking stage IVA gallbladder cancer who underwent a hepatopancreatoduodenectomy. The 64-year-old man was admitted to the local hospital with a chief complaint of high fever, hypochondrolgia and jaundice. One month later, he transferred to Tsukuba University Hospital with a hard palpable fixed large tumor in the right hypochondrium. Computed tomography and ultrasonography showed a tumor originating from the gallbladder extending to the adjacent liver parenchyma, as well as nodes in the hepatoduodenal ligaments approaching the head of the pancreas. Endoscopic retrograde cholangiopancreatography failed to exhibit the gallbladder despite the visualization of irregular narrowing of the common hepatic duct. Angiography demonstrated encasement of the right hepatic artery and narrowing of the right portal vein. On the other hand, the level of serum carbohydrate antigen 19-9 was within normal range. Based on those findings, a right hepatic lobectomy with pancreaticoduodenectomy was conducted under the preoperative and intraoperative diagnosis of gallbladder cancer; stage IVA. The gross findings of the surgical specimen showed an ill-defined yellowish hard mass, but microscopic examination demonstrated xanthogranulomatous cholecystitis. The presented case shows that xanthogranulomatous cholecystitis can mimic an advanced gallbladder carcinoma when the severe chronic inflammatory changes have extended to the liver hilum down to the head of the pancreas. However, the normal level of tumor markers in all clinical courses might be a reason to consider xanthogranulomatous cholecystitis instead of gallbladder cancer. Even when the correct diagnosis is made, the possibility that the adjacent organs should be resected is not remote.

Cholangiopancreatography, Endoscopic Retrograde↗