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Biomedical subjects

S Kaseda

Publications and source records attributed to S Kaseda.

At least 37 records · Page 2Linked to original sources
PubMed1998

[Dermal application of lisuride on parkinsonism induced by 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) in the common marmoset and on cases with Parkinson's disease].

Dermal administration is a nonoral drug delivery system that can keep the concentration of a drug in the body at a proper level for a long time. This is suitable especially in patients in the advanced stages of Parkinson's disease with a wearing-off phenomenon (short duration of effects on antiparkinsonian drugs), or in postoperative patients who cannot be treated with oral administration. We studied the effects of lisuride, a dopamine receptor agonist, in the dermal application on MPTP-treated common marmosets and on 5 patients with Parkinson's disease. Lisuride was applied to 4 x 5 cm of skin of the abdomen of monkeys. In patients with Parkinson's disease, lisuride was applied to the skin of the chest. The agent reversed akinesia of MPTP-treated animals within 30 min following the application and relieved the animal of parkinsonism for 5 days at a dose of 2 mg/kg. In patients, the dermal application of lisuride increased the duration of the ON period at doses of 1 to 2 mg/kg. These results suggest that the dermal application of lisuride is a useful treatment in parkinsonism.

1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine↗
PubMed1997

Increased dopamine turnover in the putamen after MPTP treatment in common marmosets.

The differences in dopamine turnover rate between the putamen and the caudate nucleus in the striatum lesioned by a neurotoxin 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) were studied in the common marmoset, a small New World monkey. Systemic administration of MPTP damaged equally and dose-dependently nigrostriatal dopaminergic neurons projecting both to the caudate nucleus and the putamen. The compensatory increase of dopamine turnover, however, occurred more prominently in the putamen than in the caudate. The neural connection and function of the caudate nucleus and the putamen have been differentiated anatomically or physiologically. The compensatory increase of dopamine turnover rate is another different aspect of functions between the caudate nucleus and the putamen. Dopaminergic neurons projecting to the putamen showed more prominent cell loss than those projecting to the caudate in Parkinson's disease or related disorders. The selective augmented turnover rate of lesioned dopaminergic neurons might be, at least partly, involved with selective degeneration of nigrostriatal neurons projecting to the putamen.

1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine↗
PubMed1997

Lobectomy with extended lymph node dissection by video-assisted thoracic surgery for lung cancer.

BACKGROUND: Between September 1992 and September 1996, we performed 88 VATS (video-assisted thoracic surgery) lobectomies and two VATS pneumonectomies. METHODS: The indications for surgery were 68 cases of lung cancer, nine cases of bronchiectasis, six cases of tuberculosis, and seven cases of benign lesions. Of the 68 cases of lung cancer, 36 were treated by VATS lobectomy with extended lymph node dissection for clinical stage I lung cancer, making full use of recently developed devices for thoracoscopic surgery, such as roticulating endoscissors, miniretractors, endoclips, and harmonic scalpels. RESULTS: Twenty-four lymph nodes were resected on average (range, 10 to 51) by VATS. This number was comparable to lymph nodes resected in open thoracotomy during the same period. Among the 36 patients who underwent extended lymph node dissection, 20 showed no lymph node metastasis postoperatively (stage I), while 16 had N1 or N2 cancer. All patients with stage I cancer have survived 4 to 36 months (median: 17 months) with no signs of recurrence. CONCLUSIONS: This survival of stage I lung cancer after VATS is comparable to that of open thoracotomy. We thus believe that VATS lobectomy with extended lymph node dissection can be an alternative to standard posterolateral thoracotomy for stage I lung cancer.

Adenocarcinoma↗
PubMed1997

Ambulatory blood pressure monitoring in diagnosing a pheochromocytoma of the urinary bladder. A case report.

A patient is presented in whom the preoperative diagnosis of an intravesical pheochromocytoma was facilitated by noninvasive ambulatory blood pressure monitoring. A fifty-two-year-old Japanese man suffered headache and palpitation after micturition. Cystoscopy revealed an intravesical tumor. To investigate whether his symptoms were associated with an elevation of blood pressure, the authors monitored his ambulatory blood pressure automatically for twenty-four hours. The patient was also instructed to activate the recording manually upon the onset of symptoms. As a result, elevations of blood pressure were apparent following micturition. The twenty-four-hour urinary excretion of norepinephrine was elevated on the day of the blood pressure monitoring. Pheochromocytoma was suspected and was confirmed by histopathologic studies following the operation. Thus, ambulatory blood pressure monitoring may be useful in detecting the transient hypertension induced by micturition, which can provide preoperative evidence of pheochromocytoma of the urinary bladder.

Blood Pressure Monitoring, Ambulatory↗
PubMed1997

Ultrasonographic assessment of regional differences in atherosclerotic lesions in patients with hypertension, diabetes mellitus, or both.

We evaluated risk factors involved in regional differences in atherosclerotic lesions in patients with hypertension, diabetes mellitus, or both. Using ultrasonography, we examined the brachial, common carotid, and common femoral arteries in 65 hospitalized Japanese patients (15 controls, 18 patients with hypertension, 16 with diabetes mellitus, and 16 with both hypertension and diabetes mellitus). They ranged in age from 39 to 81 yr, mean 60.3 yr. The thickness of the intima-media complex of the far wall was measured, and the severity of atherosclerotic plaques was graded according to maximal lumen stenosis. The intima-media thickness in the carotid and femoral arteries was significantly greater in the hypertensive patients and the hypertensive patients with diabetes than in the controls. Severity of plaque was greater in the hypertensive patients with diabetes than in the controls. Plaque grades were higher in the carotid and femoral arteries than in the brachial artery. Multiple regression analysis revealed that age and mean blood pressure were strongly associated with the intima-media thickness in all three arteries. In the femoral artery, cigarette smoking and hyperglycemia also significantly correlated with the intima-media thickness. Plaque grades increased with age in the carotid and brachial arteries, while in the femoral artery the grade increased with cigarette smoking and serum cholesterol concentration. These findings suggest that the extent of atherosclerosis and its underlying risk factors differ among arterial sites. In addition, risk factors may partly differ according to the stage of atherosclerosis. To prevent or reverse atherosclerosis, the above differences should be taken into account.

Adult↗
PubMed1996

Circadian variations of blood pressure in patients with sequelae of carbon monoxide poisoning.

It has been shown that carbon monoxide poisoning causes necrosis of the globus pallidum and the cerebral cortex, and a diffuse demyelination of the cerebral subcortical white matter, resulting in the impairment of the higher brain functions manifested as memory disturbances, apraxia, and agnosia. The purpose of the present study was to determine the effects of the lesions in the brain caused by carbon monoxide poisoning on the circadian changes in blood pressure and pulse rate. We measured the ambulatory blood pressure in 15 male patients with the sequelae of acute carbon monoxide poisoning and 16 age- and sex-matched controls. Using either brain computed tomography or brain magnetic resonance imaging, we determined that seven patients had lesions in the globus pallidum bilaterally, four had lesions in the parietotemporooccipital lobe bilaterally, and five had multiple deep white matter lesions. Circadian variations of blood pressure and pulse rate did not show any significant differences in either group. The average 24-h blood pressures were 120.8 +/- 2.2 (systolic)/74.1 +/- 1.5 mm Hg (diastolic) in the patients and 117.4 +/- 2.7/74.5 +/- 2.1 mm Hg in the controls. The daytime (6:00 to 21:00) and nighttime (21:00 to 6:00) blood pressures were 127.3 +/- 2.3/78.0 +/- 1.5 mm Hg and 109.7 +/- 2.4/67.4 +/- 1.7 mm Hg in the patients, and 121.6 +/- 2.9/77.5 +/- 2.2 mm Hg and 110.0 +/- 2.7/69.3 +/- 1.8 mm Hg in the controls, respectively. Furthermore, there were no differences in cardiovascular and plasma catecholamine responses induced by either a head-up tilt or a cold pressor test between the two groups. It is concluded that diffuse or multiple lesions in bilateral cerebral hemispheres caused by carbon monoxide poisoning per se do not affect the circadian changes in blood pressure and pulse rate observed in normotensive subjects.

Aged↗
PubMed1994

Circadian blood pressure variation in non-insulin-dependent diabetes mellitus with nephropathy.

We studied a circadian blood pressure variation in relation to the progression of diabetic nephropathy in patients with non-insulin-dependent diabetes mellitus (NIDDM). Age, duration of diabetes, body mass index and glycemic control did not differ among the groups of patients with normo-, micro- and macroalbuminuria. None of the patients received antihypertensive drugs. There were no differences in renal and autonomic functions between normo- and microalbuminuric groups, but these functions were impaired in the macroalbuminuric group. The rise in blood pressure was more apparent in 24-h ambulatory blood pressure (AMBP), especially during night-time, as compared with casual blood pressure. Such blood pressure rise was in accordance with the progression of nephropathy. However, pulse rate did not differ among the three groups. The nocturnal fall in blood pressure was blunted in the micro- and macroalbuminuria groups, but evident in the normoalbuminuric group. In the latter, daytime systolic blood pressure (SBP) was significantly higher than night-time SBP (123 +/- 5 mmHg vs. 113 +/- 3 mmHg, P = 0.002). In contrast, in the former two groups of patients, there were no significant differences in SBP between daytime and night-time (134 +/- 9 mmHg vs. 134 +/- 9 mmHg, ns, for microalbuminuria and 159 +/- 8 mmHg vs. 165 +/- 7 mmHg, ns, for macroalbuminuria). Urinary albumin excretion was significantly correlated with night-time SBP (r = 0.48, P = 0.015), but not with daytime SBP (r = 0.30, ns).(ABSTRACT TRUNCATED AT 250 WORDS)

Albuminuria↗
PubMed1994

Infected right atrial thrombus and pulmonary emboli associated with a perforated jejunal diverticulitis.

We describe a patient with an infected right atrial thrombus and pulmonary embolism who died suddenly. Jejunal diverticulitis, which was found at autopsy, was suspected to be the source of the bacterial thrombus. The 41-year-old female patient was admitted because of dyspnea and syncopal attacks. Physical examination on admission revealed an obese woman with a body temperature of 36.5 degrees C, systolic heart murmur and abnormal diastolic heart sound. Two-dimensional echocardiography revealed a strand-shaped mass in the right atrium. Lung blood perfusion scintigraphy revealed multiple perfusion defects in both lung fields. She suddenly developed severe dyspnea leading to death on the 6th hospital day. At autopsy, a strand-shaped organized thrombus was found in the right cardiac chambers. Microscopically, the thrombus was found to be infiltrated with numerous gram-positive cocci, leukocytes and a small number of gram-negative cocci. Most of the major pulmonary arterial branches were occluded by bacterial thromboemboli, and multiple pulmonary infarctions were found in both lungs. A perforating diverticulum with microabscess was found in the jejunal mucosa which was assumed to be the source of the bacterial thromboembolism.

Adult↗
PubMed1994

[A case of acute disseminated encephalomyelitis with pathologically-proven acute demyelinating lesion in the peripheral nervous system].

We present a case of acute severe demyelination affecting both CNS and PNS with pathological evidence. A 62-year-old man presented with acute onset of coma preceded by common cold-like symptoms. He was diagnosed as acute disseminated encephalomyelopathy (ADEM), and died of brain herniation in two weeks. At autopsy, in addition to severe demyelination of the white matter of the central nervous system, there was widespread acute demyelinating process in the peripheral nervous system. Myelin destruction by macrophage was most conspicuous in the spinal nerve root with preservation of the axon cylinder. So far the association of hypertrophic demyelinating neuropathy was reported in cases of multiple sclerosis. However, there have not been any papers in which substantial involvement of both CNS and PNS in cases of ADEM except for the clinical report by Amit. Antigenic cross-reactivity between CNS and PNS against myelin proteins or other antigens like glycolipid may elicit similar immune responses producing demyelination.

Acute Disease↗
PubMed1994

[Lobectomy under thoracoscopic guidance].

From September '92 to November '93, 15 lobectomies were performed under thoracoscopic guidance. After a thoracoport was inserted through the seventh intercostal space to conduct the operation utilizing a monitor, a six to ten cm incision was made in the fifth intercostal space. The pulmonary arteries and veins were divided after stapling with an Endo GIA or Roticulator 30-VIII. The lobar bronchus was stapled with a Roticulator 30-3.5, 30-4.8 or an Endo TA and affected lobes were resected. In cases of lung cancer, lymph node dissection has become possible as well due to the improvement of endoscopic instrumentation.

Aged↗
PubMed1994

[Treatment of hemopneumothorax under thoracoscopic guidance: a case report].

A 32-year-old man was admitted to our hospital complaining of chest pain and increasing dyspnea. Chest X-ray on admission revealed a collapsed lung and an air fluid line in the left hemithorax. Shock developed following drainage of 1,500 ml hemorrhagic pleural fluid. Following blood transfusion, emergency surgery was carried out. At operation under thoracoscopic guidance, a bleeding artery originating from the apex of the thoracic cavity and a bulla on the upper lobe were noted. The artery was successfully ligated with surgical clip, and the bulla was resected using EndoGIA. This case report indicates that hemopneumothorax can be safely operated on under thoracoscopic guidance after the patient has recovered from shock by adequate blood transfusion.

Adult↗
PubMed1994

[Skip metastases of the lymph nodes in bronchogenic carcinoma].

Of the 800 patients who underwent pulmonary resection and mediastinal lymph node dissection for lung cancer, 19.4% had skip metastases of the mediastinal nodes. The survival rate of this group was better than that of patients who had involvement of the pulmonary nodes as well as mediastinal nodes. There was a higher rate of skip metastases in upper lobe carcinoma than in lower lobe carcinoma, and lower lobe carcinoma frequently metastasized to the upper mediastinal nodes, especially to tracheobronchial and subcarinal nodes.

Adult↗
PubMed1993

Cell-cycle analysis detecting endogenous nuclear antigens: comparison with BrdU-in vivo labeling and an application to lung tumors.

The versatility of non-radioactive cell-cycle analysis in detecting endogenous nuclear antigens of the proliferating cells was evaluated. Optimal conditions for immunostaining varied in fixation and pretreatment procedures among antigens, bromodeoxyuridine (BrdU), Ki-67 epitope, DNA polymerase alpha and PCNA. A significant correlation between BrdU labeling index (LI) was observed in each positive ratio (PR, positive/total neoplastic cells) for nuclear antigens in tumor-sections which had been labeled in vivo with BrdU. The best correlation was observed in Ki-67 PR (y = 1.26x + 2.5; y = Ki-67 PR; x = BrdU LI; r = 0.97). To determine its prognostic value, Ki-67 analysis was applied to the surgically resected lung tumors. Ki-67 PR were different according to the histologic types of the tumors: 47.8 +/- 3.4% in small cell carcinoma; 29.5 +/- 3.5% in squamous cell carcinoma; 28.3 +/- 4.7% in large cell carcinoma; 15.2 +/- 1.8% in adenocarcinoma and 0.1 +/- 0.1% in mature carcinoid tumor. When the mean value was used to divide each type to a higher or lower proliferative activity (15% Ki-67 PR for adenocarcinoma and 30% for squamous cell carcinoma), the group with the lower Ki-67 PR showed a significantly more favorable prognosis than that of a higher ratio. Ki-67 PR was not correlated with other pathologic factors such as size, lymph node metastasis or pleural involvement. Non-radioactive cell-cycle analysis was feasible and useful for detecting endogenous nuclear antigens even in the lung tumors, particularly when the analysis was coupled with histologic typing.

Antibodies, Monoclonal↗
PubMed1993

[Tracheobronchial injury: clinical analysis of 17 consecutive cases].

Consecutive 17 tracheobronchial injury caused by blunt chest trauma were reviewed. 14 patients were injured by traffic accidents, 2 by fall from the high, and one by accident during play in the house. 16 were male and one was female. Patient's age range from 4 to 60 years (average 25). Site of tracheobronchial injuries were scattered and there were not found risky area. Several problem to rescue tracheobronchial injuries are discussed. To maintain the ventilation in the patient of carinal injury, it is supposed that jet ventilation may be a possible method. For the infant victims, it is difficult to evaluate the injury using bronchofiberscopy. It is recommended that repair of tracheobronchial injury may be undergone as soon as the general condition becomes enough for anesthesia. On a technical aspect, stay suture should be put at the healthy site because those injuries are larger than expected before operation. For the victims with cerebral injury or shock, respirator is necessary for ventilatory management. In those cases adequate sedation and muscle relaxation should be applied.

Adolescent↗
PubMed1993

[Treatment of invasive thymoma using low dose and extended-field irradiation including hemi-thorax or whole-thorax].

The records of 10 patients treated for invasive thymoma with low-dose and extended-field irradiation including hemi-thorax or whole-thorax are reviewed. Six patients were in stage III. They were treated with up to 15 Gy hemi-thorax irradiation which was followed by shrinkage of the radiation field after removal of tumor. Five of them have lived 4 to 10 years, while one remaining patient died of uncertain cause. Four patients had stage IVa thymoma. Two patients in an earlier stage were treated with irradiation alone; whole-thorax irradiation of up to 20 Gy followed by local irradiation. Those two patients, however, developed severe pulmonary infection secondary to irradiation pneumonitis. Furthermore, local relapse was observed in one patient who died of respiratory insufficiency after 6 years. In the remaining 2 patients in stage IVa, intensive chemotherapy was administered before whole-thorax irradiation of up to 15 Gy. One of these patients is alive with no evidence of recurrence for 5 years, while the other died of a disease not related to thymoma. These facts indicate that whole-thorax irradiation combined with chemotherapy may be of value in preventing local relapse with stage IVa thymoma.

Adult↗
PubMed1993

[Bullectomy utilizing EndoGIA under thoracoscopic guidance].

We report 5 cases of pneumothorax successfully treated with an endoscopic GIA stapling device (EndoGIA) under thoracoscopic guidance. There were no complications such as air leak or bleeding, and patients were discharged 2 to 7 days after operation. Surgical procedure utilizing EndoGIA has been proved to have advantages such as less pain, early return to normal activity and more cosmetic incision.

Adolescent↗