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Biomedical subjects

M Motegi

Publications and source records attributed to M Motegi.

At least 37 records · Page 2Linked to original sources
PubMed1996

Sneddon's syndrome (livedo racemosa and cerebral infarction) presenting psychiatric disturbance and shortening of fingers and toes.

A 24-year-old man with livedo racemosa and psychiatric disturbances, manifesting as low intelligence (IQ 80) and delusions, had anti-cardiolipin antibody and showed shortening of the fingers and toes. A skin biopsy of the livedo lesion revealed endoarteritis obliterans, being compatible with Sneddon's syndrome. MRI of the brain demonstrated multiple infarction and moderate cortical atrophy. A single photon emission tomography of the brain showed a marked reduction of the blood flow in the front-temporal lobe. These findings might relate to the psychiatric disturbance. After intravenous administration of cyclophosphamide and the start of oral prednisolone, the anti-cardiolipin antibody level decreased and his physical condition improved. However, a low dose of haloperidol is still necessary to maintain his mental condition.

Adult↗
PubMed1995

Lumbar spinal fusion using the Diapason system.

Lumbar spinal fusion with the Diapason system was performed on 58 patients at Toho University Ohmori Hospital from November 1991 to November 1994. The first 44 consecutive patients were followed for more than 1 year, including 34 cases with degenerative diseases. Those 34 cases consisted of 22 men and 12 women, ages 19-78 years (average 47.4), with 49 vertebral levels; these patients were followed for an average of 26.3 months. The clinical improvement and rate of bony union after 1 year of surgery were examined and the intervertebral angulatory motion degree of fused vertebrae was measured using a radiographic functional photo image during 1 year. We also performed an experimental study to evaluate the rigidity of this system. There were no severe complications. Although there was no instrument breakage or screw migration, two cases of rod migration were observed in L5-S1 arthrodesis. A mean improvement rate of 84.3% in the Japanese Orthopaedics Association (JOA) score was revealed. Thirty-three of 34 (97.1%) patients demonstrated successful arthrodesis after their initial procedure. In 10 segments (20.4%) 3-5 degrees of angulatory mobility were still retained, and no angulatory motion was observed in 27 segments (55.1%) 3 months after the surgery; however, no angulatory motion was observed in 44 segments (89.8%) 1 year after the surgery. In our biomechanical study, we observed that the anterior intervertebral space became narrow and mobile with loading, but when the loading was removed, the space reverted to the initial site. This movement was thought to be due to a certain elasticity in the rod and screw, and not loosening at the connection level. This system was evaluated based on the results of both clinical and biomechanical study. Notwithstanding the fact that this method has been evaluated as semirigid fusion, it does provide satisfactory bony union in posterolateral fusion, with excellent clinical results.

Adult↗
PubMed1995

[Systemic lupus erythematosus with pulmonary hypertension--normalization of pulmonary artery pressure by long-term administration of beraprost sodium].

A 24-year-old woman was admitted to our hospital because of pulmonary hypertension. Five years earlier, she had been given a diagnosis of systemic lupus erythematosus. The pulmonary hypertension was believed to have been caused by pulmonary vasculitis, because pulmonary angiography, nuclear perfusion scans, and axial magnetic resonance imaging of the pulmonary artery showed no evidence of pulmonary thromboembolism. Steroids, a calcium antagonist, and home oxygen therapy did not reduce the patient's pulmonary hypertension. The level of thromboxane B2, a stable metabolite of thromboxane A2, in the pulmonary artery was abnormally high (140 pg/ml). This suggested that vasoconstriction of the pulmonary artery and microthrombosis would cause continuous pulmonary hypertension. Beraprost sodium (120 micrograms/day, p.o.) was administered. This analogue of prostaglandin I2 is a potent relaxer of vascular smooth muscle, and it inhibits platelet aggregation. The pulmonary artery pressure was normal eight months after the start of therapy with beraprost sodium.

Adult↗
PubMed1994

Vascularized iliac bone graft based on a pedicle of upper lumbar vessels for anterior fusion of the thoraco-lumbar spine.

A new option for the use of a vascularized iliac bone graft, based on the upper (first or second) lumbar vessels, has been developed. As a pedicled graft, this supero-posteriorly-based vascularized iliac bone graft can reach the vertebrae from T8 to the sacrum, and the lower sternum and thoracic cage. In this report, the vascular anatomy of the flap and clinical experience using it for anterior spinal fusion are described.

Adult↗
PubMed1994

[A case of multiple nodular pulmonary amyloidosis associated with Sjögren's syndrome].

A 58-year-old female, who had complained of dryness of the conjunctiva and mouth for nine years, was admitted to our hospital because chest X-ray films revealed increases in both the size and the number of pulmonary nodules in comparison to four years earlier. Histological findings of the salivary gland biopsy confirmed a diagnosis of Sjögren's syndrome. An open lung biopsy was performed. Histologically, the pulmonary nodules consisted of homogeneous, acellular eosinophilic materials, which were identified as amyloid by Congo red staining. Immunohistochemical examination showed the amyloid to be composed of AA protein. There were no deposits in other organs. Peribronchial lymphocytic infiltration associated with Sjögren's syndrome was present. Nodular pulmonary amyloidosis with Sjögren's syndrome is very rare condition. To our knowledge, this case is only the ninth to be reported in the literature.

Female↗
PubMed1993

Stereocontrolled synthesis of beta-2'-deoxy and 2',3'-dideoxynucleosides by intramolecular glycosylation.

Intramolecular glycosylation of phenyl 3-O-benzyl-2-deoxy-5-O-(4-methoxy-2-pyrimidyl)-1-thio-D-ribofuranoside and 2,3-dideoxy-5-O-(4-methoxy-2-pyrimidyl)-1-thio-D-glycero-pentofuranos ide by activation with dimethyl(methylthio)-sulfonium tetrafluoroborate followed by hydrolysis gave the corresponding beta-2'-deoxy and beta-2',3'-dideoxypyrimidine nucleoside derivatives respectively in good yields.

Deoxyribonucleosides↗
PubMed1993

[A case of so-called benign metastasizing leiomyoma responsive to progesterone].

A 47-year-old female, who had undergone hysterectomy and unilateral oophorectomy in 1975, was admitted to our hospital in 1989 because chest X-ray films revealed an increase in size and number of pulmonary nodules for two years. On admission, a left inguinal tumor was found and histologically it consisted of smooth muscle cells with nuclear atypia arranged in interlacing fascicles. An open-lung biopsy was performed. Pulmonary tumors revealed similar histology to the inguinal tumor. They were diagnosed as metastatic low-grade leiomyosarcoma, so-called benign metastasizing leiomyoma (BML), on the basis of location and history, reinforced by mild histologic atypia. The tumor contained a high progesterone receptor level (400 fmol/mg). Therefore, medroxyprogesterone acetate, 600 mg daily, was administered orally. At two years the pulmonary lesions had regressed. BML is a rare condition, considered to be pulmonary metastasis from low-grade leiomyosarcoma of the uterus. Measuring estrogen and progesterone receptors in lung biopy material may help determine the most appropriate therapy.

Female↗
PubMed1993

[Hemodynamic changes in acute pancreatitis].

Hemodynamics studies were carried out from days 1-5 following the onset of illness in 7 patients with severe pancreatitis (group A) and in 7 patients with moderate pancreatitis (group B). Patients in both groups had a higher cardiac index (CI) and a lower systemic vascular resistance (SVR) than normal patients during 5 days of illness, and patients in group A had a higher CI of 5.38 +/- 0.841 x min/m2 and lower SVR of 889 +/- 234dyn.sec/cm5 than those in group B on day 4. Patients in group A had a lower pulmonary vascular resistance than normal patients on days 1, 3, and 4, but those in group B did not show this hemodynamic change. Group A patients had a higher pulmonary wedge pressure of 11.9 +/- 8.4mmHg and depressed left ventricular stroke work index of 59.8 +/- 17.8g.m/m2 as compared with group B (5.6 +/- 3.4mmHg, 77.7 +/- 23.6g./m2, respectively). These findings indicate that a hyperdynamic hemodynamic state may exist in the early stages of moderate and severe pancreatitis and myocardial depression may be evident in severe pancreatitis.

Acute Disease↗
PubMed1992

The antecubito-radial flap for the repair of forearm defect.

The antecubito-radial flap based on the inferior cubital artery via radial artery had been transposed to the forearm defect. Through the flow of this flap is normal at cubital and that of radial vessels retrograde, good results have been obtained. Advantage of this flap was discussed in relation to the radial forearm and the antecubital flap.

Forearm↗
PubMed1992

[Two cases of Churg-Strauss syndrome with bilateral wide-spread pulmonary infiltrates].

We report two cases of Churg-Strauss syndrome. The first case was a 25-year-old woman with a one year history of bronchial asthma, who developed fever, skin eruptions, abdominal pain and mononeuritis multiplex. During treatment with prednisolone 40 mg per day, chest X-ray films showed bilateral wide-spread infiltrates. When the dosage of prednisolone was increased to 80 mg per day, these infiltrates disappeared. Skin and lung biopsy specimens demonstrated allergic vasculitis and eosinophilic pneumonia. There was no response to high-dose methylprednisolone pulse therapy for persistent severe abdominal pain and mononeuritis multiplex. Pericardial and pleural effusions with eosinophilia recurred eight months later. The second case was a 31-year-old man with a six year history of bronchial asthma, who developed fever, skin eruptions, myalgia and mononeuritis multiplex. One year later, during treatment with prednisolone 15 mg per day, bronchial asthma with eosinophilia relapsed and chest X-ray films showed bilateral patchy infiltrates. Skin biopsy specimens demonstrated eosinophilic infiltrates and necrotizing vasculitis, while lung biopsy specimens demonstrated eosinophilic infiltrates and small granulomas. With additional administration of cyclophosphamide, he has had no evidence of active disease for six years. In both cases, the neurological symptoms persisted despite treatment with high doses of steroids, and during tapering of prednisolone, vasculitis syndrome relapsed. Therefore, long-term careful surveillance is necessary in this disease.

Adult↗
PubMed1992

[Three cases of pulmonary actinomycosis].

Three cases of pulmonary actinomycosis are reported. Case 1 was a 33-year-old man complaining of hemosputum. A large mass lesion was noted in the right upper lobe and surgically resected. Actinomycosis was diagnosed pathologically. The second case was a 41-year-old man with lung abscess. An actinomyces species was cultured by percutaneous aspiration biopsy. He was effectively treated with clindamycin. The third case was a 46-year-old man with a chronic cough and cavitary lesion. Gram staining of sputum revealed sulfur granules. Piperacillin was administered with prompt response. All three cases had dental disease and two had diabetes mellitus. In patients with a mass lesion or those with lung abscess not effectively treated by cephem antibiotics, actinomycosis should be suspected especially when diabetes mellitus and/or dental disease coexists. Adequate treatment may not always require long-term antibiotics.

Actinomycosis↗
PubMed1987

Clinical analysis of multiple organ failure in burned patients.

Severely burned patients often show various degrees of organ failures, and when several vital organs are involved mortality becomes extremely high. A study was undertaken to elucidate the aetiology and clinical significance of multiple organ failure (MOF) in burned patients. One hundred and fifty-eight burned patients were analysed for organ failures in five vital organs or systems, the heart, lung, liver, kidney and blood clotting system. There were 91 organ failures observed in 34 patients, of which 26 had MOF. The most frequently affected organ was the lung, followed by the heart, kidney, liver and the blood clotting system. The mortality rate was 76.9 per cent in MOF and 1.5 per cent in non-MOF patients. Septicaemia was closely associated with the development of MOF. Also, inhalation injury and 'shock' were contributing factors to the morbidity. Five extensively burned patients had an early development of MOF without infectious foci and this type of early MOF was attributed to endotoxaemia possibly originating from the patient's own intestinal flora.

Adolescent↗
PubMed1986

Free compound rib-latissimus dorsi osteomusculocutaneous flap in reconstruction of the leg.

The use of a free compound rib-latissimus dorsi osteomusculocutaneous flap is described, for reconstruction of the tibia and soft tissue of the leg. The entire flap depends on the thoracodorsal artery for its blood supply. Dye injection studies of the artery demonstrated continuity between it and the intercostal artery, which is the periosteal vessel of the rib, through a dense network of vascular communications. The longest follow-up reported is three years and ten months. Follow-up showed that the use of this compound flap produced uniformly well-contoured soft tissue coverage and bony structure that thickened almost to the same dimensions as the tibia. The transferred tissue was examined by x-ray and bone scintigraphy, and was found to be viable.

Adult↗
PubMed1984

[Abdominal injury].

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Abdominal Injuries↗