PubMed Health⌕ Search

Biomedical subjects

M Katsuragi

Publications and source records attributed to M Katsuragi.

At least 19 recordsLinked to original sources
PubMed1998

[Effects of long-term administration of cilostazol on chronic cerebral circulatory insufficiency--with special reference to cerebral blood flow and clinical symptoms].

This report deals with a study of the effectiveness, safety, and usefulness of long-term administration of Cilostazol for the improvement of cerebral blood flow and clinical symptoms in 24 patients with Chronic Cerebral Circulatory Insufficiency. Cerebral blood flow was investigated quantitatively using the Patlak plot method. Cilostazol was orally administered for 209 days on average. In the global improvement rating assessed on the basis of all subjective symptoms, the final improvement rate, comprising all cases showing moderate or better improvement, was 52.2%. Regarding individual symptoms, dizziness, orthostatic syncope, dull headache, and headache showed improvement rates of 30% or more. Regional cerebral blood flow (rCBF) was increased in both cerebral and cerebellar hemispheres. The global improvement rating for subjective symptoms and the delta % rCBF for every region except the cerebral hemispheres were positively correlated. However, there was no positive correlation between the global improvement rating for psychiatric symptoms and the delta % rCBF for any region. Regarding individual subjective symptoms, dizziness showed an especially high positive correlation of above 0.7 between the improvement rating and the delta % rCBF in the left temporal lobe, basal ganglia, and cerebellum. Headache was observed as an adverse drug reaction in 8 of 24 patients, but it disappeared with reduction of the dose or discontinuation of administration. No other severe adverse drug reactions were noticed. In summary, it was concluded that Cilostazol was useful for treating chronic cerebral circulatory insufficiency.

Aged↗
PubMed1996

Pheochromocytoma-related myocardial damage following delivery.

We present the case of a 35-year-old woman whose pregnancy was complicated by the rare condition of transient pheochromocytoma-related myocardial damage. Short-duration left ventricular dysfunction was apparently caused by acute non-transmural myocardial infarction provoked by coronary artery vasospasm rather than catecholamine-induced cardiomyopathy. Forty-eight days after onset, a 50 x 55 x 35 mm tumor was excised and histologically confirmed to be a pheochromocytoma.

Adult↗
PubMed1994

A case of a primary hepatic tumor causing segmental changes on imaging and its relation to Zahn's infarct.

A 69-year-old female was admitted to our hospital for further examination of an intrahepatic mass which had been found while undergoing a complete physical examination. The mass measured 4 cm in size and was located in the medial segment (S4) of the liver. On computed tomography (CT), S4 was observed to be 'atrophied' and was well enhanced segmentally. A celiac angiogram showed segmental staining, and a transarterial portogram demonstrated portal stoppage of S4 from the left branch. However, no segmental intensity difference was seen on magnetic resonance imaging (MRI). An aspiration biopsy showed adenocarcinoma and thus an operation was performed under a tentative diagnosis of intrahepatic cholangiocarcinoma. The postoperative diagnosis of the tumor was combined hepatocellular and cholangiocellular carcinoma. However, no histological abnormality was seen in S4, contrary to the expectation of Zahn's infarct. In this study, we discuss the mechanism and imaging findings of Zahn's infarct, the possible reasons as to why no pathological change was seen in S4, as well as stress the rarity of reports on Zahn's infarct in cases of portal thrombus due to hepatocellular carcinoma.

Aged↗
PubMed1994

[A case of neurofibromatosis with occlusion of multiple cerebral artery, moyamoya phenomenon and scoliosis].

Cases of cerebrovascular occlusive lesion with neurofibromatosis have rarely been reported. We report here, the case of a 57-year-old woman who twice had sudden onset of brain hemorrhage. She had a family history of neurofibromatosis. Her elder daughter and her niece had a diagnosis of neurofibromatosis and examination showed café au lait spots and neurofibroma over the body, accompanied with scoliosis. CT scans revealed subependymal hemorrhage at the first onset of cerebral bleeding and secondly showed a high-density mass at the left basal ganglia. SPECT(99mTC-HMPAO) showed decreased activity in the left frontal and temporal lobe. Angiogram revealed multiple occlusive lesions of the cerebral arteries, including occlusions of the bilateral anterior cerebral artery and the right middle cerebral artery at the proximal portion and stenosis of the left posterior artery at the proximal portion. Abnormal vascular networks (so called Moyamoya phenomenon) at the base of the brain were also seen bilaterally. Seizinger and others have found a genetic locus of this disease in the use of genetic engineering, and Riccardi showed that mast cell is related to the tumorous growth of neurofibroma and suggested a possibility of medical treatment for growing neurofibroma by stabilizing mast cell function with ketotifen. We anticipate the treatment for this disease will be established in recent years.

Cerebral Angiography↗
PubMed1993

An analysis of autopsy findings in 108 patients who died after valve replacement.

The pathological findings and the causes of death were reviewed in 108 patients who had received 142 heart valve prostheses (52 mechanical and 90 bioprostheses) at the National Cardiovascular Center in Osaka, Japan, from 1977 to 1991. Rheumatic heart disease was the major underlying disease (60.2%), and the age distribution at death ranged from 21 to 80-year-old. Survival duration after the surgery extended from 0 day to 9 years. Thirty-three patients (30.6%) died of perioperative complications such as myocardial haemorrhage and damage, or from heart failure which had been evident prior to the operation, a cause of death which pre-dominated in patients who died within 1 week of surgery (15/17; 88.2%). Thirty-eight patients (35.2%) died of prostheses-related problems such as prosthetic valve failure (cuspal tears and calcifying destruction of the xenograft), thromboembolism, and prosthetic valve endocarditis. Endocarditis was frequent in patients who had survived longer than 1 year (25/33; 75.8%). None of the patients died of prostheses-related problems within 1 week. Non-infectious valve failure was more common in patients with bioprostheses than in those with mechanical valves; thromboembolism showed the opposite association. Prosthetic valve infective endocarditis was nearly equal in frequency in both types of valve.

Adult↗
PubMed1993

Pulmonary hypertension due to tumor emboli: a report of three autopsy cases with morphological correlations to radiological findings.

Three cases of pulmonary hypertension caused by tumor emboli to the lungs are described. Two of the three cases had a clinical diagnosis of pulmonary thromboembolism until surgical embolectomy, and the other had a diagnosis of primary pulmonary hypertension. Autopsy disclosed chondrosarcoma, choriocarcinoma and gastric cancer as the primary tumors, respectively. Pulmonary vascular obstruction due to tumor embolism leading to pulmonary hypertension is a previously rare clinical entity, and obstructed pulmonary vessels are believed to tend to be small vessels. We compared the autopsy and radiological findings and concluded that pulmonary tumor embolism involved not only the small peripheral arteries but also the segmental and/or lobar arteries.

Adult↗
PubMed1993

Detection of enteroviral genome and its significance in cardiomyopathy.

Myocarditis is an important disease that can lead to dilated cardiomyopathy (DCM). Using the polymerase chain reaction (PCR), we examined whether viral genomes were present specifically in the hearts of viral myocarditis or DCM patients in our autopsy series and compared the results with their clinicopathological features. We applied three different criteria of myocarditis to fully describe the histological features. The presence of a viral genome was detected by PCR but was not specific in DCM or myocarditis. PCR might be helpful in the diagnosis of viral myocarditis, when combined with other clinical information.

Adult↗
PubMed1993

Cell infiltration caused deterioration in the prognosis of patients with clinical diagnosis of dilated cardiomyopathy (DCM): application of biopsy criteria of myocarditis to 42 autopsy cases.

Many investigators consider viral myocarditis as an important cause of a dilated cardiomyopathy (DCM)-like state. In assessing myocarditis in endomyocardial biopsy samples, two sets of criteria, i.e., the Edwards and the Dallas criteria, are employed. However, no criteria have been established for cell infiltration in autopsy cases, nor have biopsy criteria for myocarditis been applied in autopsy cases. We analyzed the clinicopathologic features and small round cell infiltration in 42 autopsy cases whose clinical diagnoses were DCM, employing both the Edwards and the Dallas criteria. Of the 42 cases, 12 (29%) showed positive results for both sets of criteria. These 12 positive patients were proven to have myocarditis by autopsy and they showed more severe clinical features than 30 cases with negative cell infiltration.

Autopsy↗
PubMed1993

[Histopathological analysis of cellular infiltration in 42 autopsied cases of dilated cardiomyopathy].

Myocarditis is a possible cause of dilated cardiomyopathy (DCM), but criteria for cell infiltration in autopsy cases have not been established. The significance of cell infiltration was evaluated in 42 autopsied cases of DCM which met the diagnostic criteria of the Ministry of Health and Welfare, among 1,700 serial autopsy cases at the National Cardiovascular Center, using the W.D. Edwards and Dallas criteria. Microscopic examinations used sections of the heart along the short axis at the upper one-third and lower one-third levels. Infiltration of small round cells was divided into 3 layers: the epicardial layer, myocardial layer and endocardial layer. Three types of fibrosis were classified: interstitial, focal (less than 1 cm in greatest diameter), and massive (equal to or exceeding 1 cm in greatest diameter). The mean age at death was 50.3 years, but female patients died earlier than male patients. The period of congestive heart failure was 5 years; with a family history of cardiomyopathy in 10% of all patients. The subgroup which fulfilled both criteria consisted of 12 patients (28.6%; positive group). The other subgroup consisted of 30 patients (71.4%; negative group). Cell infiltration tended to be greater in the epicardial layer and less in the endocardial layer. This trend was more prominent in the positive group. Interstitial fibrosis was seen in 73.8% of all patients. Clinically, the positive group was younger at death with higher serum LDH values and lower % fractional shortening on echocardiograms, all statistically significant. Other trends were thinner left ventricular walls, smaller left ventricular cavities and lower cardiac weights in the positive group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Thallium-201 myocardial SPECT in Bland-White-Garland syndrome: two adult patients with inferoposterior perfusion defect.

A myocardial 201TI SPECT examination was conducted both prior to and following surgery of two adult patients with an anomalous left coronary artery originating from the pulmonary artery (Bland-White-Garland syndrome). In this syndrome, the anterior wall is usually affected first. Preoperative examination demonstrated an inferoposterior perfusion defect. In both patients, the right coronary artery was markedly dilated, and a significant left-to-right shunt formation was observed. Both patients were diagnosed as possibly having coronary steal syndrome. A prolonged inadequate blood supply to the right coronary region may cause inferoposterior cardiomyopathy. In the postoperative examination, myocardial perfusion markedly improved in one patient whose preoperative SPECT showed redistribution in a delayed scan. Thallium-201 SPECT was therefore found to be useful in assessing both the preoperative and postoperative myocardial perfusion.

Adult↗
PubMed1992

Cardiac rupture complicating hemorrhagic infarction after intracoronary thrombolysis.

An 80-year-old woman with acute myocardial infarct received intracoronary thrombolysis by a large dose of urokinase four hours after the onset of chest pain. Despite the patient having no chest pain after intracoronary thrombolysis and her general condition being stable, she died suddenly on the 4th hospital day. Autopsy revealed hemopericardium due to cardiac rupture, which occurred at the center of the transmural hemorrhagic infarction of the anteroseptal wall. The massive hemorrhagic infarction was promoted by reperfusion from thrombolytic therapy. She had also classic risk factors for cardiac rupture, such as hypertension, senility, female gender, and first acute myocardial infarct. Therefore, the present case demonstrated that hemorrhagic infarction increased the incidence of cardiac rupture.

Aged↗
PubMed1992

Coronary artery embolism with special reference to invasive procedures as the source.

Since 1978, there have been sporadic reports of coronary artery embolism caused by cardiac catheterization, percutaneous transluminal coronary angioplasty, and other invasive procedures. To determine whether coronary artery embolism has increased with the wider application of such procedures, we searched for patients with coronary artery emboli among the autopsy cases with suspected acute myocardial infarction at the National Cardiovascular Center from 1977 to 1990. Of the 28 patients with emboli, 10% of the total autopsy cases of myocardial infarction was confirmed in 18. Infarction was diagnosed clinically in only six of these patients and directly caused the death of 11 of the 18 patients. In contrast to previous reports, where a minority of coronary emboli were caused by instrumentation, 14/28 patients in our series had coronary embolism due to invasive procedures, including eight patients with atheromatous emboli. half of the myocardial infarcts caused by embolism were hemorrhagic. Thus, coronary emboli are not so rare as once thought, and they may increase further with the progress of invasive diagnostic and surgical interventions. The possibility of coronary embolism thus needs to be kept in mind by all clinicians in the cardiovascular fields.

Adult↗
PubMed1992

Polyotia. A case report.

An extremely rare case of polyotia is presented. A seven-month old male had a congenital deformity of the right auricle, appearing like a large accessory auricular appendage. It had a small helix-like protuberance connecting to a very long helical crus; there was a conchal cavity between the external auditory meatus and the protuberance. Surgery led to good results. The surgical procedure is described and the literature concerning polyotia discussed. Our diagnostic criteria for polyotia and the accessory auricular appendage are presented.

Cartilage↗
PubMed1989

[Diagnostic imaging of gallbladder carcinomas with special reference to ultrasonographic findings. Retrospective review with emphasis on diagnostic problems in preoperatively undiagnosed gallbladder carcinomas].

The diagnostic images of twenty surgically-resected gallbladder carcinomas were retrospectively reviewed for correlations with macroscopic findings. Among them, nine cases were correctly diagnosed preoperatively; 11 were not. Macroscopically, all correctly diagnosed lesions were elevated type carcinomas. Preoperatively undiagnosed lesions were comprised by 9 superficial and 2 elevated types of carcinomas. None of these 11 undiagnosed carcinomas could be identified on retrospective review of the ultrasonographic findings. Thorough evaluation of the gallbladder wall was prevented by gallstones and/or emphysema in 6 cases, and by contraction of the gallbladder in 4 cases. There was no definite evidence of wall thickening in one case of diffuse superficial carcinoma involving the muscle layer. As for lesion detectability, computed tomography was inferior to ultrasonography, though the former demonstrated localized wall thickening of the gallbladder in the majority of cases of elevated type carcinomas. Intravenous cholangiographic findings were non-specific.

Adenocarcinoma↗