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Biomedical subjects

M Furuyama

Publications and source records attributed to M Furuyama.

At least 37 records · Page 2Linked to original sources

Growth and achievement of large- and small-headed children in a normal population.

Growth and school achievement were examined at regular intervals in the 926 children enrolled in the Prospective Longitudinal Study on the Development and Growth in Nagoya City, conducted from 1964 to 1981. Among these children, 10 had head circumferences of more than 2 standard deviations (SD) above the mean and 6 ones of less than 2 SD below the mean at least once in each infancy and adolescence. The heights and weights of the large-headed children were greater than the means, and those of the small-headed children lower than the means. These physical characteristics were already observable at birth. Achievement in primary and secondary schools over 9 years was excellent in 5 (50%) and average in the other 5 of the large-headed children, and average in 5 (80%) and poor in the other one of the small-headed children. Therefore, head size is correlated to both physical growth and school achievement.

Adolescent↗

The effect of sustained stellate ganglion stimulation on left ventricular contractility in the dog.

Although a progressive reduction in left ventricular contractility during sustained left stellate ganglion stimulation has been well documented, there have been no reports on the contractile state after nerve stimulation. Left ventricular contractility after cessation of 60 min of electrical (10 V. 10 Hz. 1 msec) left stellate ganglion stimulation has been assessed in open chest dogs. Before and 15 min after stimulation, left ventricular contractility was evaluated by the end-systolic pressure-segment length relationship using ultrasonic crystals during a stepwise aortic constriction to increase left ventricular afterload. Restimulation of the left stellate ganglion was also performed 15 min after cessation of the first stimulation. After sustained left stellate ganglion stimulation, the end-systolic points shifted to the right from the control and the slope of multiple pressure-segment length coordinates significantly decreased (102.5 +/- 16.1 to 76.5 +/- 10.2 mmHg/mm, mean +/- S.E., p less than 0.05, n = 5), indicating a depression of left ventricular contractility. Increased left ventricular dP/dt max and norepinephrine level in the coronary sinus gradually returned to near base line during 60 min of stimulation. These reduced responses lasted for at least 15 min after cessation of stimulation. The myocardial norepinephrine content was reduced to 0.59 +/- 0.08 (mean +/- S.E.) ng/mg wet tissue from 0.90 +/- 0.15 of the control level (p less than 0.05). These data suggested that left ventricular contractility decreased after sustained cardiac sympathetic nerve stimulation, probably due to norepinephrine reduction in the myocardium.

Animals↗

Serum valproate concentrations in epileptic children with favourable responses.

The lower limits of the "therapeutic range" for serum levels of sodium valproate (VPA) were evaluated in epileptic children showing a benign clinical course. Twenty-five outpatients, aged 5 to 16 years, whose seizures were well controlled over three years with VPA alone, were studied. Venous blood was taken 1.1 to 5 hrs after the morning dose. Serum VPA concentrations at steady-state after receiving the maintenance doses to control seizures were determined by enzyme immunoassay. The patients were divided into three groups according to the seizure type and the age at onset; A and B: patients with tonic and/or clonic seizures, aged below 3 yrs (n = 11) and 3 to 11 yrs (n = 6), respectively, C: those with absence seizures, aged 4 to 11 yrs (n = 8). The serum concentrations in A (47.8 +/- 21.6 micrograms/ml, mean +/- SD) were significantly (p less than 0.02) lower than those in groups B and C (85.2 +/- 14.0 and 73.0 +/- 17.4 micrograms/ml, respectively). VPA concentrations below 50 micrograms/ml were seen in 6 patients (55%) in group A. It was concluded that many epileptic children, whose ages at onset were below 3 yrs, with tonic and/or clonic seizures could be controlled even with low initial serum concentrations below the "therapeutic range".

Adolescent↗

Bioavailability of a film-coated tablet of valproate in nonfasting volunteers.

The bioavailability of a film-coated tablet of valproate (VPA) in nonfasting volunteers was studied. Ten healthy adults received a single 200 mg (mean 3.55 mg/kg) film-coated tablet, 15 minutes after breakfast. Venous blood was then taken at regular intervals of up to 4 or 7 hours after the dosage, and the serum VPA concentrations were determined by means of a fluorescence polarization immunoassay. VPA was slowly absorbed with the peak concentrations occurring 1.5 to 4 hours after the administration. The mean concentration (Cmax) and extent of absorption (area under the concentration-time curve) between 1 and 4 hours were 22.2 micrograms/ml and 59.3 micrograms.h/ml, respectively. It was concluded that Cmax with a film-coated tablet of VPA can be detected if blood is taken at around 3 hours after the dosage under nonfasting conditions.

Adult↗

Growth in head circumference from birth to fifteen years of age in Japan.

Growth charts for head circumference in Japanese children from birth to fifteen years of age are presented. The charts were compiled from the pooled data obtained in a prospective longitudinal study on development and growth in Nagoya city. An adolescent growth spurt in head circumference was found and this spurt occurred earlier in girls than in boys. Heads were smaller up to the age of 10 years and larger beyond that age than those in Nellhaus' composite charts. The heads of children of both sexes in our study are definitely smaller than those of children born in the United Kingdom in the same period, but they are considerably larger than those of children born in Japan more than 50 years ago. Therefore, the standards for head circumference will differ from country to country and from generation to generation.

Adolescent↗

Sexual difference in properties of 5 alpha-reductase in microsome of rat submandibular glands.

The properties of 5 alpha-reductase activity in the submandibular glands of rats were investigated using microsomal fraction in the presence of NADPH, and we found a sexual difference in these properties. The formation of 5 alpha-dihydrotestosterone and 5 alpha-androstane-3 alpha, 17 beta-diol from testosterone demonstrated 5 alpha-reductase in the rat microsomal fraction of this tissue sample. Apparent michaelis constants (Km) of the 5 alpha-reductase activity for testosterone was 1.02 x 10(-6) M for the female tissue. Microsomal fraction of submandibular glands of male rats had two Kms and were determined as 1.12 x 10(-6) M and 1.01 x 10(-5) M. The lower Km of 5 alpha-reductase for male rats was similar to for the females.

Animals↗

Idiopathic arterial calcification in 9-year-old boy: a successful reconstruction for ilio-femoral occlusion.

We treated a 9-year-old boy suffering from underdevelopment of the length as well as circumference of the left lower extremity due to idiopathic arterial calcification of the left ilio-femoral artery. There was no deposition of calcium on the other arteries and tissues of the body. He had undergone aorto-internal iliac bypass graft with resection of the calcific iliac and superficial femoral arteries in the National Fukuoka Central Hospital when he was 4 years old, but the graft became occluded. He was admitted to the University of the Ryukyus Hospital. The common femoral artery was completely occluded with severe deposition of calcium on the wall and with gritty contents. The profunda femoris artery and the proximal part of the superficial femoral artery were also completely occluded with organized thrombi. Re-establishment of blood flow to the ischemic left lower extremity was performed with an ilio-femoral cross-over synthetic bypass and femoro-popliteal saphenous vein bypass graft, in situ. The patient has been well with adequate pulses of the pedal and posterior tibial artery 8 months after surgery.

Arterial Occlusive Diseases↗

Construction of internal arteriovenous fistulas for hemodialysis using Inokuchi's vascular stapler.

Using Inokuchi's vascular stapler, arteriovenous fistulas with an end-to-end fashion for hemodialysis were constructed in 80 patients (82 limbs) with chronic renal failure. In 76 patients and 76 limbs (95%) of a total of 80 patients, the fistulas were patent and hemodialysis could be effectively carried out. Use of Inokuchi's vascular stapler facilitated a rapid construction of subcutaneous end-to-end arteriovenous fistulas, and no particular training in vascular surgery was required for the operator. Since the anastomosis was constructed in an end-to-end fashion, complications such as swollen hand, peripheral steal syndrome and cardiac failure were nil.

Arteriovenous Shunt, Surgical↗

Ultrasonic flow wave pattern as a prognostic indicator in peripheral arterial reconstruction.

A prognostic flowmetric study on 80 reconstructed arteries of the lower extremity was carried out to assess the flow wave patterns detected using a bidirectional doppler flowmeter. In 21 of 80 arteries, changes in the flow wave pattern were noted. For 10 of 21 affected arteries, an immediate arteriography revealed localized stenotic lesions at the distal anastomosis, in a short segment of the implanted autogenous vein graft or at the proximal host artery. Immediate repairs for the lesions were successfully performed by a minor surgery in 8 of 10 cases and the flow wave pattern reverted to normal. Two were not successful as the occlusion was complete before attempting the repair. The remaining 11 are now under conservative management as these patients refused further surgery. The ultrasonically driven flow wave pattern proved to be a useful indicator to assess the patency of the reconstructed peripheral artery to detect possible stenosis and thereby to take proper corrective measures and hence prevent a late occlusion.

Arterial Occlusive Diseases↗

Venous reconstruction by endvenectomy with temporary arteriovenous fistula for stasis syndrome of lower extremity: experimental and clinical studies.

Effect of the temporary arteriovenous fistula on venous reconstruction for stasis syndrome of the lower extremity was studied experimentally and clinically. The canine iliac vein was replaced with an autogenous vein graft in which the intimal surface was roughened by scrubbing with sponge. A temporary arteriovenous fistula which was closed surgically three or four weeks later was created between the femoral vessels. The patency rate for twenty-one grafts was 80.9 per cent for one to thirty-six weeks (mean 8 weeks), in contrast to complete failure in the control group in which no arteriovenous fistula was created. Adequate healing of the luminal surface of the grafts were experimentally demonstrated by light microscopic examination and en face silver staining of the endothel-like cells with the aid of patent arteriovenous fistula for three weeks. This procedure was clinically applied in four patients with stasis syndrome of the lower extremities. Good function of the reconstructed venous segments in three of four patients was observed for the last 3 to 8 years after the operations. A looping technique using 2-0 monfilament nylon around the fistula devised by us was very helpful to make easy the shunt closure later. Open endvenectomy with a temporary arteriovenous fistula is believed to be an acceptable approach for segmental chronic occlusive lesion in the iliac vein.

Adolescent↗

Long-term results of reconstructive surgery for aorto-iliac arterial occlusive lesions.

We report a review of 215 reconstructions for aorto-iliac arterial occlusive lesions, involving 156 patients. At 13 years, the cumulative patency rate of 158 aorto-femoral or aorto-iliac dacron synthetic bypass prostheses was 71.6 per cent as compared to 52.7 per cent at 5 years for 22 blunt endarterectomies and 47.4 per cent at 6 years for 35 axillo-femoral bypass prostheses. Of the 158 synthetic bypass prostheses, the cumulative patency rate at 13 years was 85.1 per cent in cases with no occlusive involvement of the peripheral arteries, significantly higher (p less than 0.03) than the 39.3 per cent patency rate at 7 years in cases in which associated femoro-popliteal occlusive lesions were not treated. At 12 years, the patency rate was 53.2 per cent in cases in which associated femoro-popliteal occlusive lesions were treated during the same reconstructive intervention, i.e. markedly higher (p less than 0.08) than in patients in whom the degree of outflow in the distal vessels was poor. Our findings indicated that, in order to achieve a satisfactory long-term patency rate, it is important to treat associated occulusive lesions in the femoro-popliteal arteries.

Adolescent↗

Long-term results of reconstructive surgery for femoro-popliteal arterial occlusive lesions.

A retrospective review of 156 reconstructions performed for femoro-popliteal arterial occlusive lesions in 141 patients was carried out in terms of the reconstructive procedure and the degree of out-flow in the distal vessel. The cumulative patency rate for 95 autogenous vein grafts was 60.7 per cent at 12 years and higher than the 27.4% patency rate for 50 endarterectomies (p less than 0.001). All of 11 synthetic bypass prostheses failed with late thrombosis within 3 years after operation. The cumulative patency rate in cases with good distal run-off vessel and those with fair distal run-off vessel were 77.1% at 11 years and 57.3% at 12 years, respectively, and these values were significantly superior to 10.3% in cases with poor distal run-off vessel. The patency rate for 41 in situ grafts was 72.2%, being superior to 65.5% for 42 free grafts.

Adolescent↗

Comparative study on the fibrinolytic activity of pseudointima in varying types of autovein grafting.

Three types of autovein grafting procedures have been commonly employed for peripheral arterial reconstruction, that is, non-reversed, reversed and in-situ autovein grafting, and these procedures were comparatively studied in dogs to assess the best one for grafting. In the fibrinolytic activity of the internal surface of the grafts, as measured by standard fibrin plate method and Todd's fibrin slide technique, the in-situ autovein graft showed the highest activity, 139.5% in the mean, followed by 18% (mean) in the reversed autovein graft and 5.2% (mean) in the nonreversed autovein graft. The extent of fibrous proliferation of the pseudointima was least in the in-situ graft followed by the reversed and the non-reversed graft. These results suggest that preservation of the vasa vasorum is the most important factor to minimize fibrous proliferation of the graft pseudointima and to maintain high fibrinolytic activity on the internal surface of the graft. Consequently, the in-situ autovein grafting appears to be the most suitable method to ensure peripheral arterial continuity following surgical reconstruction.

Animals↗

A new surgical approach to extensive arterial occlusion of lower extremity--femoro-popliteal open endarterectomy with arteriovenous shunt.

A revascularized surgery for extensive arterial occlusive lesions of the lower extremities, namely open endarterectomy of the occluded femoro-popliteal artery with arteriovenous shunt, was devised. The procedure is specially indicated to the extensive arterial occlusion of the lower extremity for which the conventional reconstructive vascular surgery is not applicable. The patency of the reconstructed femoro-popliteal arteries are ensured by virture of an arteriovenous shunt and newly developed collaterals from the reopened genicular network is expected to provide effective blood flow to peripheral parts. From 1967 to 1975, this procedure was applied to 59 extremities in 53 patients, all of whom had extensive arterial occlusion from the femoral artery to the periphery with impending ulcer and severe rest pain. Fourty-five out of 59 extremities had remarkable improvement of the ischemic symptoms and signs at the time of discharge. Long-term effectiveness was shown in 34 out of 59 extremities or 58 per cent.

Arterial Occlusive Diseases↗