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Biomedical subjects

M Hamawaki

Publications and source records attributed to M Hamawaki.

At least 37 records · Page 2Linked to original sources

[A case of Fontan operation for complex heart disease with good post-operative course by the management of hypothermia in coming off from cardiopulmonary bypass].

A 8-year-old boy with a complex heart disease was underwent Fontan operation with Glenn operation, and had a good post-operative course by the management of hypothermia in coming off from cardiopulmonary bypass around 31 degrees C. The hypothermic therapy was thought to be effective in acute stage after Fontan operation, because it improved tachycardia, decreased the systemic metabolism, redistributed the systemic arterial blood flow and increased the urinary output.

Child↗

[Intrapericardial lipoma with stenosis of the left bronchus and pulmonary artery].

In a 1-year-6 month-old girl with asthma, a chest magnetic resonance imaging revealed an intrapericardial lipoma at the site of the transverse sinus behind the great arteries. The tumor compressed the left bronchus and pulmonary artery resulting in the stenosis. Under cardiopulmonary bypass, the tumor was successfully removed. The stenosis of the left bronchus and pulmonary artery were released.

Bronchi↗

[Radical correction of paracardiac type IIb of total anomalous pulmonary venous connection using pedicled flaps of right atrium and atrial septum].

Surgical results of total anomalous pulmonary venous connection (TAPVC) has been improved in recent years, however, late development of pulmonary venous obstruction was our concern in its total correction in early infancy. In the cardiac type of TAPVC, in which the pulmonary veins were connected to the right lateral wall, prosthetic patch is conventionally used in diversion of pulmonary venous flow into left atrium. It seemed favorable to repair this subset without using prosthesis. A 3-month-old female with TAPVCIIb according to Darling's classification underwent total correction on September 22th, 1988. Two pedicled flaps were developed using the right atrial wall and the atrial septum to create a pulmonary venous channel to divert arterial blood into left atrium and absorbable sutures were used throughout. Right atrium was entered through a vertical incision in its body and all the pulmonary veins were found in a recess in the lateral wall of the right atrium. Atrial septal defect in the cranial aspect of the fossa ovalis was enlarged by cutting the primum tissue along the right limbus and its caudal margin so as to form a pedicled flap attached to the left limbic tissue. Then the flap was sutured along the limbus to create a roof of the fossa ovalis. The second flap was made in the middle of the lateral atrial wall and was used to create a tunnel from the recess to the atrial septal defect. The defect in the right atrial wall was closed directly and no prosthetic patch was used. Postoperative course was uneventful and echocardiogram showed wide pulmonary venous channel draining into the left atrium.

Female↗

[Therapeutic effects of cefminox in the treatment of various infections of infants and children].

The therapeutic effects of cefminox (CMNX, MT-141), a new synthetic cephalosporin antibiotic, were examined in the treatment of various pediatric infections. Patients treated were infants and children ranging from 12 days after birth to 12 years old suffering from bronchopneumonia in 10 cases, urinary tract infection in 6 cases, pharyngitis in 2 cases, cervical lymphadenitis in 2 cases, suppurative meningitis, cervical abscess, mastoiditis, peritonitis, bronchitis in 1 case each, total of 25 cases. As regards method of administration, CMNX from a vial was dissolved in physiological saline or distilled water for injection, and the solution was administered by 3 to 5 minutes one shot intravenous injection (15 cases), or CMNX was diluted with large volume parenteral product and administered by 30 to 60 minutes drip infusion (10 cases). The dosage of the drug was 21.3 to 165.5 mg/kg/day. The administration was continued for 3 to 13 days except 1 case. As regards clinical efficacy, good or excellent results were obtained in all cases except 3 cases, 1 case was urinary tract infection with cerebral palsy and vesicoureteral reflux, and 1 case was bronchopneumonia with Down syndrome and endocardial cushion defect, the other was suppurative meningitis. Total effective rate was 88%. No clinical side effects nor abnormal laboratory findings obviously attributable to CMNX were observed.

Anti-Bacterial Agents↗

Regional mapping of catalase and Wilms tumor--aniridia, genitourinary abnormalities, and mental retardation triad loci to the chromosome segment 11p1305----p1306.

Gene dosage effects for catalase (CAT) were studied in two unrelated patients with an interstitial deletion involving 11p13 to determine precisely the sites of the genes for CAT and the Wilms tumor--aniridia, genitourinary abnormalities, and mental retardation triad (WAGR) in the 11p13 band. Case 1 had the aniridia-Wilms tumor association, and case 2 showed the AGR triad. The karyotypes identified by high resolution banding techniques were 46,XY,del(11)(pter----p13::p11.11----qter) for case 1 and 46,XY,t(2;17)(q23;q25),del(11)(pter----p13::p11.2----qter) for case 2. In both cases, the distal breakpoints of the deleted chromosomes 11 appeared to have occurred on the middle portion of 11p13 (11p1305----p1306). The level of erythrocyte CAT activities in case 1 was reduced (47% of normal), while that in case 2 was normal. The results suggested not only that both the CAT and WAGR should be mapped to chromosome region 11p1305----p1306, but also that in this region the CAT locus is more distally placed than the WAGR locus. Because of the proximity of the two gene loci, assays of erythrocyte CAT may be useful to identify a submicroscopic deletion in some patients with sporadic aniridia and to predict a risk of developing Wilms tumor.

Abnormalities, Multiple↗

[HBs antigen-positive adult type liver cancer in a child with sustained remission induced by infusion of antineoplastic agents into the hepatic artery].

A 9-year-old boy with non-resectable hepatocellular carcinoma was treated with irradiation and intra-hepatic arterial infusion of antitumor agents. His blood was positive for hepatitis B surface antigen (HBs Ag), but negative for hepatitis B e antigen (HBe Ag). Maternal transmission was suspected, because his mother's blood was positive for HBs Ag and his grand mother died from hepatic cirrhosis. The patient received a total dose of 4000 rad in 30 fractions. A chemotherapy cycle consisted of 5-FU (6 mg/M2/day, given continuously), EX (300 mg/M2, given on 1st, 3rd, 5th, 7th, and 9th week), VCR (1.5 mg/M2, on 2nd, 4th, 6th, 8th, and 10th week), and ADM (30 mg/M2, on 13th and 16th week). Since 6 months after the initiation of the chemotherapy, alpha-fetoprotein has become negative (less than or equal to 100n g/ml), and now, 2 years and 11 months after the diagnosis was settled, the patient remains a disease free state. His blood continues to be positive for HBs Ag.

Antineoplastic Agents↗

Diagnostic and prognostic significance of chromosome abnormalities in marrow and mitogen response of lymphocytes of acute nonlymphocytic leukemia.

Chromosomes of bone marrow from 28 patients with acute nonlymphocytic leukemia (ANLL) (26 with AML, 2 with AMMoL), 19 of whom had chromosome abnormalities, were studied; 11 cases exhibited previously unreported karyotypic abnormalities. The marrows of two cases had 8-21 translocations associated with an iso-X chromosome in the female patient and with 9q13- and a missing Y in the male patient. Usually, AML patients with a 8-21 translocation have been considered to have a good prognosis; however, our cases had rather short survival times. Therefore, the prognosis of AML with an 8-21 translocation but associated with other abnormalities is still not clear. Centromere spreading (CS), which was originally reported in marrow cells of megaloblastic anemia (B12 and folic acid deficiency), was detected in leukemic cells, disappeared during remission, and reappeared on relapse. These findings suggest that CS may be a new type of abnormality in AML. In two patients with atypical hypoplastic anemia and hemolytic anemia, chromosome abnormalities were detected at the anemic stage. One case with CS was associated with atypical hypoplastic anemia and developed AML after 1 year; the other with 48,XY,+i(1q),+3,/12 and -14 had hemolytic anemia and developed AMMoL 3 weeks later. Interestingly, identical clones were detected both before and after the clinical diagnosis of leukemia. These cases strongly support the concept that some chromosome abnormalities precede the clinical manifestations of leukemia. The present study also revealed that lymphocytes in ANLL respond poorly to PHA in the presence of high numbers of blasts but do respond well to mitogens during remission. Therefore, the response of lymphocytes to PHA may serve as one criterion for determining remission.

Adult↗

[Therapeutic effects of cefmenoxime in the treatment of various infections on infants and children].

The therapeutic effects of cefmenoxime (CMX), a new synthetic cephalosporin antibiotic, were examined in the treatment of various pediatric infections. Patients treated were infants and children ranging from one-month-old to 13-year-old suffering from pharyngitis in 2 cases, bronchopneumonia in 3 cases, cervical lymphadenitis in 2 cases, urinary tract infections in 7 cases, tympanitis in 2 cases, suppurative meningitis, sepsis, subcutaneous apostem, acute enteritis, chest wall apostem, phlegmon, staphylococcal scalded skin syndrome in 1 case each, a total of 23 cases. As regards method of administration, CMX from a vial was dissolved in physiological saline or distilled water for injection, and the solution was administered by 3 to 5 minutes one short intravenous injection (14 cases), or CMX was diluted with large volume parenteral product and administered by 30 to 60 minutes drip infusion (9 cases). The dosage of the drug was 30 to 200 mg/kg/day; 103 mg/kg/day and under in 21 cases, 150 mg/kg/day and 200 mg/kg/day in 1 case each. The administration was continued for 3 to 27 days. As regards clinical efficacy, "good" or "excellent" results were obtained in all the cases except 2 cases, one was alpha-Streptococcus acute tympanitis supervening neuroblastoma, and the other was Pseudomonas urinary tract infection. The efficacy rate was 91.3% with excellent in 11 cases, good in 10 cases. As regards bacteriological effects, of 13 strains of Gram-positive bacteria, 10 strains were eliminated and 3 strains were not changed, while of 10 strains of Gram-negative bacteria, 8 strains were eliminated and 2 strains were reduced; thus CMX showed better results against Gram-negative bacteria rather than against Gram-positive ones. The antimicrobial activity of CMX against Gram-positive bacteria was inferior to those of CTM and CEZ, but CMX showed the highest antimicrobial activity against Gram-negative bacteria. No clinical side effects nor abnormal laboratory findings obviously attributable to CMX were observed.

Adolescent↗

[Therapeutic effects of cefoxitin in the treatment of various infections in children (author's transl)].

In order to ascertain the therapeutic effects of cefoxitin (CFX), a new semisynthetic cephamycin antibiotic, it was administered to pediatric patients with several infections. There were 8 patients with acute respiratory disease (ARD), 3 with urinary tract infection (UTI), 2 with appendicitis complicated with peritonitis, 2 with scarlet fever, one each of left coxitis, infected medial cervical cyst, febrile illness after a V-P shunt operation, purulent parotitis and intractable diarrhea with fever, namely, a total of 20 patients aged from one month to 11 years 6 months. A CFX vial which contained 1 g of CFX was used in two ways, i.e., one shot intravenous injection and drip infusion. The dosage of the drug varied from 57 to 121 mg/kg/day and the administration was continued from 2 to 20 days. Clinical effects were evaluated as follows: when cardinal symptoms disappeared within 3 days it was considered to be 'excellent'; within 5 days 'good'; and no change of clinical symptoms within 5 days 'poor'. The bacteriological effect was expressed as 'eliminated', 'unchanged' and 'undetermined'. Clinical efficacy evaluated as 'excellent' occurred in 11 cases, 'good' in 8 cases and 'poor' in 1 case, the efficacy rate being 95.0%. When classified by the disease, the efficacy rate was as follows: 'good' to 'excellent' in 7 out of the 8 cases of ARD, 'excellent' in all of the 3 cases of UTI, 'good' and 'excellent' in the 2 cases of scarlet fever and in the 2 cases of peritonitis, 'excellent' in each case of left coxitis, purulent parotitis and intractable diarrhea with fever, 'good' in each case of infected medial cervical cyst and febrile illness with a V-P shunt operation. From the bacteriological point of view, 'eliminated' occurred in 5 cases, 'reduced' in 1 case and 'undetermined' in the 2 cases of ARD, 'eliminated' in all of the 3 cases of UTI, 'eliminated' in 1 case and 'undetermined' in the 1 case of peritonitis, 'undetermined' in the 2 cases of scarlet fever, 'eliminated' in each case of infected medial cervical cyst and purulent parotitis and 'undetermined' in the other cases. Antimicrobial efficacy measured by MIC was compared with CEZ and CET, and the results were as follows: CFX was inferior to the two cephalosporins for S. aureus, it was between CEZ and CET for H. influenzae and H. parainfluenzae, and CFX was superior to CEZ and CET for E. coli. All of the 3 antibiotics had poor antimicrobial efficacy for P. aeruginosa and S. faecalis. There were neither clinical side effects nor abnormal laboratory findings which were obviously attributable to CFX during and after administration of the drug.

Age Factors↗