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Biomedical subjects

K So

Publications and source records attributed to K So.

35 records · Page 2Linked to original sources

[The clinical examination for posttransfusion hepatitis].

We studied viral hepatitis, type A, type B, type D and type non A non B. Type A hepatitis was diagnosed by the serological examination for IgM type anti-HA and total anti-HA. Several cases were negative for IgM type anti-HA within 2 weeks after the onset of type A hepatitis. Type B hepatitis was diagnosed by RIA for serum HBs antigen. Several cases of type B hepatitis were negative for serum HBs antigen but positive for IgM type anti-HBc, or hepatocytes were positive for HBs antigen. These cases had high titer of total anti-HBc. Type D hepatitis was diagnosed by RIA for anti-delta in serum and by PAP stain for delta antigen in hepatocytes. All cases of type D hepatitis were positive for anti-delta in their serum and positive for delta antigen in their hepatocytes, they were positive for HBs antigen. Incidence of HDV infection was 0.7% in HBV carrier. The incidence of non A non B hepatitis was 27.6% in 105 recipients and the incidence of its progression to the chronicity was 20.0%.

Adult↗

[Detachable balloon treatment of vertebral fusiform aneurysms].

Percutaneous embolization using a detachable balloon in six cases of vertebral fusiform aneurysm is reported. Location of these aneurysms were as follows; 5 aneurysms in the distal vertebral artery (2 proximal to the posterior inferior cerebellar artery; PICA, 2 distal to the PICA and 1 where the PICA was undetectable), and one aneurysm in the extracranial vertebral artery. Three cases suffered from subarachnoid hemorrhage (dissecting aneurysms) and other cases showed lower cranial nerve palsy (giant aneurysm) or posterior fossa ischemia. Most of the cases were treated immediately after conventional diagnostic angiography, especially those cases with subarachnoid hemorrhage (within 4 days after the last attack). Under local anesthesia, a catheter was positioned in the affected vertebral artery either trans-femorally or trans-axillary. The detachable balloon was placed proximal to the aneurysm and test occlusion was performed for 15-20 minutes (the tolerance test or balloon Matas' test). After it was confirmed that there had been no neurological deterioration, the vertebral artery was permanently occluded by detachment of the balloon. The procedure was successful in all cases. Thrombosis of aneurysms was confirmed either by follow-up angiography or by autopsy. However, two cases who were grade V (Hunt & Kosnik) at admission died of severe vasospasm. PICA was preserved through either ipsilateral or contralateral collaterals. Detachable balloon occlusion of the vertebral artery for fusiform aneurysm is thought to be less invasive, more indicative and a safer procedure compared to conventional surgical proximal occlusion therapy.

Adult↗

[A case of cerebral embolism caused by atrial myxoma--superselective fibrinolytic therapy].

A 37-year-old man was admitted to our clinic 3 hours after the onset of cerebrovascular accident with right hemiparesis and total aphasia. On admission, we started combined administration of mannitol, vitamin E, phenytoin (Sendai Cocktail) and perfluorochemicals to protect ischemic brain. Left cerebral angiography revealed occlusion of the left middle cerebral artery involving its perforating arteries. Following the performance of angiography, vascular balloon catheter was introduced into the embolus, and fibrinolytic agent (urokinase) was continuously injected. Soon after the injection of 240,000 unit urokinase, recanalization of left middle cerebral artery was shown by repeated cerebral angiography performed 5.5 hours after the onset. On his clinical course, left hemiparesis and aphasia were improved step by step, and 1 week later, he could walk by himself with minor neurological deficits. Further examination revealed that myxoma was located on left atrium by echocardiography. Within 1 week, the patient was transferred to cardio-surgical unit, and myxoma was successfully removed. Now he is in good health and has returned to his job. Usually cerebral embolisms result from atrial myxoma cause severe cerebral infarction. Here we reported a case of cerebral embolism by myxoma and recanalized using fibrinolytic agent by balloon catheter injection. The damage will be reduced if the duration of occlusion is limited, so this method will be helpful to treat cerebral embolism.

Adult↗

[A new superselective balloon catheter--all-silicone catheter with a floppy tip].

We have introduced concept of "chemical" embolization and have tried to develop a new agent which would enable us to embolize the lesion with one-shot injection. Such an agent must be able to occlude diffusely the lesion distal to the catheter. This has made it mandatory to develop a new catheter which can be introduced into the vessel as close to the lesion as possible with fewer risks of clot formation and/or vessel damage. A new superselective balloon catheter for angiography and infusion of liquid embolizing materials has been developed. This catheter consists of a proximal relatively stiff silicone catheter, a short distal thin-walled flexible silicone catheter and silicone balloon. These three silicone components are connected by silicone adhesives. The distal catheter allows us to catheterize fine arteries such as lenticulostriates, while the proximal catheter assures easy manipulation. This balloon catheter can be used for superselective angiography and infusion of liquid embolizing materials. It has been used on nine patients; one with a dural arterio-venous malformation (AVM), four with meningiomas, and four with brain and spinal cord AVMs. In the case of dural AVM and meningiomas, it was possible to easily introduce into the middle meningeal artery distal to the foramen spinosum. In addition, in one of the cases of meningioma, we were able to catheterize one of the main feeding pedicles beyond the pterion. Chemical embolization was carried out in 5 cases with good results. In the case of brain and spinal cord AVM, useful information was obtained from the superselective angiography.(ABSTRACT TRUNCATED AT 250 WORDS)

Angiography↗

Increased numbers of lymphocytes with single class surface immunoglobulins in reactive hyperplasia of lymphoid tissue.

Forty-seven lymph nodes and one stomach exhibiting reactive hyperplasia from 40 patients were examined by morphologic and immunologic methods. Twelve lymph nodes and one stomach from ten patients had a significantly increased number (greater than 25%) of lymphocytes, with single class surface immunoglobulins or plasma cells, and plasmacytoid lymphocytes secreting single class immunoglobulins. In three cases, a diagnosis of malignancy was subsequently made on the basis of morphological and immunological evidence of tumor in other tissue. Five patients had collagen disorders, two had a persistent unexplained hypergammaglobulinemia, and two had no recognized associated disease. The significance of an increase of B lymphocytes with single class surface immunoglobulins in these cases is presently not clear, but patients with similar findings should have extensive investigation and persistent follow-up.

Adult↗

Visual callosal, corticotectal and corticogeniculate projections in golden hamsters.

Visual callosal projections were identified in the hamster by terminal degeneration after total transection of the corpus callosum. A dense trilaminar callosal terminal field was observed to form a belt around area 17. The subcortical projections from area 17 were studied using the autoradiographic method. Evidence for a topographic organization is presented for projections from area 17 to the superior colluculus, the dorsal and ventral nuclei of the lateral geniculate body. The totography of the projections are in accord with known patterns of distribution of the retina upon these structures in the hamster.

Animals↗

Clinical evaluation of left ventricular function in acute myocardial infarction--analysis of factors affecting left ventricular function.

The clinical significance of the possible factors which may affect the cardiac function and prognosis of the patients with acute myocardial infarction were evaluated in 112 patients with this disease. Patients were subdivided into 4 groups according to the levels of pulmonary capillary wedge pressure (PCWP) and left ventricular stroke work index (SWI): Group I (52 patients) PCWP less than 18 mmHg, SWI less than or equal to 30 g.m/m2; Group II (18 patients) PCWP greater than or equal to 18 mmHg, SWI greater than or equal to 30 g.m/m2; Group III (15 patients) PCWP less than 18 mmHg, SWI less than 30 g.m/m2; Group IV (27 patients) PCWP greater than or equal to 18 mmHg, SWI less than 30 g.m/m2. Immediate mortality rate (4 weeks after the onset of myocardial infarction) was 17.0% in all patients and Group IV had the highest mortality rate (48.1%), in contrast to the lowest mortality rate (3.8%) in Group I. The episodes of previous myocardial infarction were noted more frequently in Group IV (74.1%) than in Groups I (7.7%) and II (11.1%) (p less than 0.001). Mean age in Group IV (68.0 +/- 5.2 (SE) years) was also significantly higher than those of the remaining 3 groups (p less than 0.001). In 55 patients without previous myocardial infarction, mean infarct size estimated from total released creatine phosphokinase (CPK) (sigma CPK) in Group IV was largest among the 4 groups, although it was similar to that in Group II: 919.0 +/- 70.0 (SE) IU/ml in Group I, 1470.0 +/- 126.0 in Group II, 958.0 +/- 107.0 in Group III and 1493.0 +/- 145.0 in Group IV. The number of involved coronary arteries differed significantly between Groups I and IV: in Group I involved coronary artery (75% narrowing) was absent or one at most, while in Group IV all 9 patients had at least one coronary lesion and 3 of 9 had triple vessel disease. In this study no significant difference was observed between the incidence of anterior and inferior myocardial infarctions in Groups I, III and IV. Thus, we conclude that age, previous myocardial infarction, infarct size and the number of involved coronary arteries may determine the cardiac function in acute phase of myocardial infarction and hence, immediate mortality of this disease.

Adult↗

Detection of endotoxin in plasma and ascitic fluid of patients with cirrhosis: its clinical significance.

Endotoxin was measured by the Limulus assay in plasma and ascites in 46 patients with cirrhosis having demonstrable esophageal varices, of whom 29 had ascites and 17 did not. It was positive in ascitic fluid in 23 (79.3%) of the former group. In plasma, a positive test was obtained in 22 (75.9%) in the group with ascites and only 4 (23.5%) without ascites, the difference being significant (P less than 0.01). Of the 23 positive ascites specimens, 17 showed high titers (greater than or equal to 10(-3) microgram per ml). Hepatic uptake of 198Au colloid was markedly reduced in 11 of the 17 patients with endotoxemia who were studied by scanning. Death occurred within 6 months in 47.8% of the patients with a positive endotoxin test, whereas only 16.7% of those with a negative test died in the same period (P less than 0.05). No hypotension was noted in patients with toxemia and only 2 ran a fever above 37.5 degrees C. Development of tolerance to endotoxin is suspected. A follow-up study has demonstrated sustained endotoxemia in some of these patients.

Ascitic Fluid↗