PubMed Health⌕ Search

Biomedical subjects

S Kitamura

Publications and source records attributed to S Kitamura.

At least 37 records · Page 2Linked to original sources
PubMed1992

[Clinical and CT-findings in hemiballismus].

We studied the correlation between clinical and CT-findings in 33 cases with hemiballismus. Of these 33 cases, 4 cases were examined by the authors and 29 cases were obtained from the literature. Cerebrovascular disease was present in 27 cases and the localization of the lesion was examined with CT. Of these 10 cases had lesions in the subthalamus, while 17 cases had lesions outside the subthalamus. In 6 cases, the location of the lesion was not recognized on CT. In cases with lesions outside the subthalamus, 11 cases had lesions in the putamen, 10 cases had lesions in the caudate. Therefore the lesion were largely located in the striatum. Typical hemiballismus was seen in 16 cases. In this group, 6 cases had lesions in the subthalamus, 5 cases had lesions in the putamen, and 3 cases had lesions in the caudate. Hemiballismus accompanied by hemichorea was seen in 17 cases. In this group, while 9 cases had hemichorea with ballismus, and 5 out of 9 cases had lesions in the caudate, 4 cases had lesions in the putamen. Thus, all lesions were located in the striatum. Eight out of 17 cases had hemiballismus with chorea. In these 8 cases, 4 cases had lesions in the subthalamus, these were 2 cases in the putamen, and 2 cases had lesions in the caudate. When all cases were examined in terms of clinical manifestations, 10 cases were considered to have lesions in the caudate and 7 out of 10 cases involved chorea. Ten cases had lesions in the subthalamus, while 6 out of 10 cases showed typical hemiballismus.(ABSTRACT TRUNCATED AT 250 WORDS)

Cerebral Infarction↗
PubMed1992

[Lipopolysaccharide binding protein enhances intratracheally administrated lipopolysaccharide-induced acute lung inflammation via a CD14 receptor].

We examined the role of lipopolysaccharide binding protein (LBP) in the airspace and the CD14 receptor on alveolar macrophages in TNF alpha production and neutrophil (PMN) sequestration in lungs induced by intratracheal injection of lipopolysaccharide (LPS). LPS alone (Salmonella minnesota wild-type; 20 ng) or LPS + LBP complex [LPS (20 ng) + rabbit LBP (500 ng); preincubated for 30 min at 37 degrees C] was injected intratracheally into isolated rabbit lungs perfused with lactate-Ringer-albumin solution. Human PMN (5 x 10(7)) were added to the perfusate after 2 hr perfusion. Samples of lung perfusate were collected every 30 min for 180 min, after which bronchoalveolar lavage (BAL) was also performed. TNF alpha concentration in the perfusate and BAL fluid were determined using a bioassay with L-929 fibroblasts. PMN accumulation in the lung was determined by myeloperoxidase assay of the lung homogenate. LPS alone did not significantly increase TNF alpha production or PMN accumulation in lungs, whereas LPS/LBP complex increased TNF alpha concentration in the perfusate and PMN accumulation. Intratracheal injection of anti-CD14 antibody (40 micrograms) with LPS/LBP complex prevented TNF alpha production and subsequent PMN sequestration. We conclude that LBP in the airspace enhances the effect of LPS on TNF alpha production via a CD14-dependent pathway, and this subsequently contributes to PMN sequestration in the lungs. Airspace accumulation of LBP secondary to increased vascular and epithelial permeability may play a critical role in the development of septic shock and lung injury by promoting TNF alpha production via a CD14-dependent mechanism.

Acute Disease↗
PubMed1992

[A case of Machado-Joseph disease--cerebral blood flow and cerebral metabolic rate of oxygen].

A 51-year-old woman, with progressive gait disturbance and dysarthria, had been diagnosed as Menzel-type spinocerebellar degeneration. Later, she developed dystonic posture of upper limbs and bulging eyes. She was diagnosed as Machado-Joseph disease from neurological findings, which consisted of cerebellar signs, pyramidal tract signs and extrapyramidal tract signs and peripheral neuropathy. She died suddenly of unknown origin. Her illness lasted about 13 years. Neuropathological findings showed moderate neuronal loss with gliosis in the subthalamic nucleus, globus pallidus, substantia nigra, dentate nucleus, oculomotor and hypoglossal nucleus and anterior horn. Positron emission tomography (PET) using 15O steady state inhalation technique revealed reduction of cerebral blood flow and cerebral metabolic rate of oxygen in not only cerebellum but also cerebral cortex. These findings are different from typical PET findings of spinocerebellar degeneration.

Brain↗
PubMed1992

[Evaluation of mediastinal lymph nodes by computed tomography in lung cancer].

It is important to evaluate hilar and mediastinal lymph node metastasis accurately, since the findings are used to determine the indications for therapies and to estimate the patient's prognosis. Computed tomography (CT) is a useful method for this purpose, but it is known that healthy people may also have lymphadenopathy up to 10 to 15 mm, and metastasis is sometimes observed in lymph nodes less than 10 mm in cases of adenocarcinoma. For this reason, it is necessary to establish an optimal criteria for measured values of lymph nodes on CT images. In this study, we compared the size of mediastinal lymph nodes on CT images and histological findings in 425 lymph nodes of 153 primary lung cancer patients resected in our hospital from 1984 to 1991. Criteria were expressed as possible criteria which can be obtained from ROC analysis with compatibility of sensitivity and specificity, and definite criteria which offer highest efficiency. We analyzed these two criteria by minor axis, major axis, their sum, and their product. As a result, minor axis offered the best criteria. The value of possible criteria was 8.7 mm (sensitivity: 73%, specificity: 70%) and definite criteria was 13 mm (efficiency: 88%) in 425 lymph nodes. Analyzed by histological type, the criteria of epidermoid carcinoma (possible criteria: 9.5 mm, definite criteria: 13 mm) were larger than those of adenocarcinoma (possible criteria: 8.3 mm, definite criteria: 11 mm). Analysed by anatomical region and histological type, the criteria of epidermoid carcinoma varied by with the location of lymph nodes, but those of adenocarcinoma were almost constant.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗
PubMed1992

Oxidation of 1,1-diphenylhydrazine to N-nitrosodiphenylamine by superoxide radical in the eye.

By microsomes obtained from bovine ciliary body, 1,1-diphenylhydrazine was oxidized to N-nitrosodiphenylamine in the presence of NADPH. This reaction was stimulated by riboflavin which was recognized to be an electron carrier. The oxidizing activity by microsomes was markedly inhibited by superoxide dismutase, but not by SKF 525-A or carbon monoxide. Similarly, the oxidation of 1,1-diphenylhydrazine to its corresponding nitrosamine occurred in varying degrees when the hydrazine derivative was exposed to visible light in the presence of photosensitizers such as riboflavin, flavin adenine dinucleotide, flavin mononucleotide, lumiflavin, lumichrome, NAD+, NADH, NADP+, or NADPH. The photochemical oxidation was inhibited by active oxygen-scavengers such as superoxide dismutase, L-ascorbic acid or alpha-tocopherol. The superoxide radical involved in the photochemical reaction was determined by measuring the oxidation of epinephrine to adrenochrome. The oxidation of epinephrine was well correlated to that of 1,1-diphenylhydrazine. Thus, the present study provided evidence that the superoxide radical is responsible for the oxidation of a hydrazine derivative to a corresponding nitrosamine by ocular tissue microsomes and by photosensitizers.

Adrenochrome↗
PubMed1992

[Late results of coronary artery bypass grafting with the internal thoracic artery].

Between November 1981 and December 1991, 755 patients underwent isolated coronary artery bypass grafting. We compared postoperative events, graft patency and survival rates of the patients who received at least one internal thoracic artery graft (n = 517) with those of the patients who had only saphenous vein bypass grafts (n = 238). No significant difference was found between the 2 groups in patient's age at the operation, female ratio and the incidence of emergency operation. The operative mortality was not significantly different in either group. Graft patency was better for internal thoracic artery grafts than for SVG (ITA grafts 97.1%, SVG 85.6% p less than 0.0001). Graft-LAD patency rate was also better for ITA grafts than for SVG (ITA grafts 97.7%, SVG 86.8%, p less than 0.0001). The incidence of late cardiac events (late cardiac death, reoperation, myocardial infarction) is lower in patients with ITA. Furthermore, patients who received ITA grafts had a better survival rate at 8 years (91.1% versus 85.3%, p = 0.048) than those who had vein bypass grafts alone. We conclude that the use of ITA grafts enhances the long-term benefits including long-term survival rate. This is the first observation in Japanese population.

Adult↗
PubMed1992

[Left ventricular performance after patch reconstruction of the left ventricular wall for postinfarction left ventricular aneurysms].

Left ventricular performance in patients with a left ventricular aneurysm (LVA) treated with patch reconstruction is largely unknown. This study consisted of 15 patients, 14 men and 1 woman, with the average age of 59 +/- 8.5 years. The resected area of LVA was 40 +/- 27 cm2. The area of the woven Dacron patch used for reconstruction was 57 +/- 19% of the resected area including the sewing rim. The EF (Ejection Fraction, 1/3FF (Filling Fraction) and PFR (Peak Filling Rate) were calculated by 99mTc equilibrium cardiac pool scintigraphic images. The A/R ratio (peak velocity during atrial kick phase/peak velocity during the rapid filling phase) was measured using Doppler echocardiography, at the mitral orifice level. These parameters were determined before and 1 to 2 months after the operation. The time course was followed for A/R ratios. The preoperative resting global EF was 0.28 +/- 0.14 (0.44 +/- 0.13 for the contractile area) and the EF during exercise was 0.31 +/- 0.14. Resting and exercise EFs improved significantly (p < 0.01) to 0.40 +/- 0.11 and 0.43 +/- 0.10 postoperatively. The 1/3FF (%) and PFR (/sec) were low before operation (1/3FF, 11.3 +/- 8.3; PFR, 1.2 +/- 0.47). Postoperatively, the 1/3FF rose to 14.8 +/- 9.3 and the PFR showed a significant (p < 0.05) increase to 1.6 +/- 0.6. The A/R ratio significantly (p < 0.05) improved from preoperative 1.76 +/- 0.46 to 0.95 +/- 0.11 on the 3rd postoperative day. This improvement was maintained until the late postoperative period, with a value of 1.14 +/- 0.29 at month 16.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1992

[A case of isoniazid (INH)-induced pneumonitis].

A 58-year-old man was referred for the evaluation of a lung nodule on chest X-ray. On admission, chest X-ray showed a solitary nodule with cavitation in the left lung field. Histological examination revealed epithelioid cell granulomas and the diagnosis of pulmonary tuberculosis was made. He was treated with INH, ethambutol (EB), and rifampicin (RFP). On the 16th day of treatment, he developed dry cough and high fever. On the 20th day, dyspnea developed and PaO2 was decreased to 38.2 Torr. Chest X-ray showed new widespread infiltrates in both lung fields and bilateral pleural effusions. The size of the cavitary lesion was decreased. Transbronchial biopsy specimen showed slight interstitial thickening, lymphocyte infiltration, and multiple granulomas. Drug lymphocyte stimulation test was positive only with INH (230%). INH-induced pneumonitis was highly suspected. All drugs was discontinued and hydrocortisone 2400 mg daily was started. He soon became afebrile, and dyspnea and dry cough resolved. Chest X-ray film showed resolution of infiltrative shadows. He was subsequently successfully treated with streptomycin, EB, and RFP without any adverse effects. To our knowledge, this is the sixth reported case of INH-induced pneumonitis.

Alveolitis, Extrinsic Allergic↗
PubMed1992

A quantitative study of postoperative luminal narrowing of the internal thoracic artery graft in coronary artery bypass surgery.

We used quantitative angiography to determine the postoperative diameter of the internal thoracic artery graft at the point close to the anastomosed site in 147 patients who received the graft for the left anterior descending coronary artery. We performed generalized multiple linear regression analysis (Type I quantification method) to assess the effects of the following factors on the internal thoracic artery graft diameter: age, gender, time of angiography, laterality of the internal thoracic artery used, presence of an undivided major side branch of the internal thoracic artery, presence of a saphenous vein graft having blood flow competition with an internal thoracic artery graft, presence of distal stenosis of the recipient left anterior descending coronary artery, severity of postoperative left anterior descending coronary artery stenosis, and presence of coronary risk factors. The standardized category scores for 25% left anterior descending coronary artery stenosis, 50% left anterior descending coronary artery stenosis, and presence of a saphenous vein graft having blood flow competition with an internal thoracic artery graft were -1.418, -0.767 and -0.622, respectively. Thus, the internal thoracic artery diameter was smaller in patients with well-preserved flow of the recipient coronary artery. The internal thoracic artery diameter had a particularly strong correlation with the degree of left anterior descending coronary artery stenosis (partial correlation coefficient: 0.670). The other factors seemed to have little or no correlation with the postoperative internal thoracic artery diameter. With the criterion that the internal thoracic artery diameter below 1.0 mm represents the "string sign" of internal thoracic artery graft, this phenomenon was observed in nine patients (6.1%). In all of these patients, left anterior descending coronary artery flow was well-preserved, and no ischemia was disclosed in the left anterior descending coronary artery-perfused area. These results indicate that internal thoracic artery grafts have flow adaptability responding to the flow demand of the recipient coronary artery and that the string sign of internal thoracic artery grafts is mainly an outcome of its physiologic characteristics.

Adult↗
PubMed1992

[A case of systemic arterialization of lung without sequestration].

Intralobar pulmonary sequestration is a congenital disease characterized by nonfunctioning lung tissue with an anomalous blood supply stemming from the systemic circulation. We report a rare case of anomalous systemic arterial supply to the lung without demonstrable pulmonary changes. It is controversial whether this abnormality, systemic arterialization of lung without sequestration, should be a subtype of sequestration complex or not. We discuss the spectrum of sequestration complex.

Adult↗
PubMed1992

[Retroperitoneal fibrosis suspected to be ureteral tumor because of its localization at the unilateral distal ureter: a case report].

The patient was a 32-year-old female with the complaint of right flank pain. Drip infusion pyelogram showed right hydronephrosis and retrograde urogram demonstrated a marked stenosis about 2 cm in length at the right distal ureter. The passage of the ureteral catheter and the contrast medium through the narrowing portion of the ureter could not be performed. The abdominal computerized tomographic (CT)-scan disclosed renal subcapsular urinoma, although no abnormal findings which caused ureteral stenosis were revealed. A suspicion of right ureteral tumor was entertained and total nephroureterectomy was performed. Histopathological diagnosis was the idiopathic retroperitoneal fibrosis, which involved the right ureter. One hundred and fifty five cases of idiopathic retroperitoneal fibrosis in the Japanese literature were reviewed.

Adult↗
PubMed1992

[Aortic valve replacement with fresh or cryopreserved aortic allograft--initial experience in Japan].

Aortic allograft valves were harvested from non-infected (bacterial or viral) cadavers within 24 hours of death with a family consent, and were sterilized by 4 degrees C antibiotic solution for 48 hours. Then, the allograft was preserved in the 4 degrees C nutrient medium (fresh; TC-199, calf serum and HEPES buffer) or in liquid nitrogen (-196 degrees C) after freezing to -80 degrees C by a programmed freezer. 10% dimethylsulfoxide (DMSO) was used for cryopreservation. Following germ-free confirmation, aortic allograft valves were implanted in 5 patients having aortic regurgitation with good results. Three fresh and two cryopreserved allograft valves were used. Although the follow-up term is very short (maximum 1 year) at the present time, the valve function is quite satisfactory, confirmed by cardiac catheterization and echocardiography. This is the first report in Japan with regard to cryopreservation of allograft valves and clinical use of fresh or cryopreserved valves. We believe that realization and progress of allograft preservation by cryo-technique and establishment of the tissue bank are important for the development of cardiovascular surgery in Japan.

Adult↗
PubMed1992

[Anesthetic management of a neonate with esophageal atresia with double tracheoesophageal fistulae].

We reported the anesthetic management of a 1-day-old female neonate (2,110 gm) with esophageal atresia combined with double tracheoesophageal fistulae, which is classified as Gross type D. Though Gross type C was suspected preoperatively, the proximal fistula was found coincidentally during the preparation of the upper pouch. Because, for one thing, the origin of the proximal fistula was close to the end of the upper pouch (1cm), and for another, the distance between the both fistulae was short (1cm). As for the proximal fistula, it was 2 mm in diameter, and it was easily sealed with the side of the endotracheal tube. No other respiratory managements were needed except frequent suctionings of copious intratracheal secretions. On the other hand, the distal fistula, 10 mm in diameter, caused hypercapnea due to hypoventilation before gastrostomy. It was so big that it is easily intubated. This type of tracheoesophageal fistula is extraordinarily rare and its proximal fistula is difficult to find before, during, and even after operation. The missing of the proximal fistula often provokes severe respiratory infections and furthermore, sepsis postoperatively. It is concluded that in all the cases of tracheoesophageal fistula, the existence of the proximal fistula should be considered without fail and managed accordingly. To diagnose correctly, the use of preoperative bronchofiberscopy is also recommended.

Anesthesia↗
PubMed1992

[Experimental study on the role of prostaglandin D2 in the pathogenesis of bronchial asthma].

Various kinds of chemical mediators have been implicated in the pathogenesis of bronchial asthma. PGD2 is a cyclooxygenase product which has various physiological effects. In this experimental study, we investigated the role of PGD2 in the pathogenesis of bronchial asthma. In a bioassay system, PGD2 caused dose-dependent contractile responses in non-sensitized guinea pig trachea and lung tissue strips. The subthreshold concentration of PGD2 in both strips was 25 ng/ml. Acetylcholine-induced contractile responses in both strips were significantly increased by continuous infusion of PGD2. In the experimental model of bronchial asthma, the levels of PGD2 were significantly increased in serum, bronchoalveolar lavage fluid (BALF) and lung tissue of sensitized guinea pigs after antigen challenge. We have also reported that the levels of PGD2 in BALF were elevated in patients with stable state bronchial asthma. These results suggest that PGD2 may be a key substance that increases airway responsiveness and induces asthmatic attacks.

Animals↗
PubMed1992

[Angioscopic prediction of late vascular patency after transluminal balloon angioplasty for arteriosclerotic obstructions of the artery of the lower extremities].

Arterial occlusion or stenosis of the lower extremity due to arteriosclerosis obliterans (ASO) was treated by transluminal balloon angioplasty (TBA). Angioscopic observation of the vascular lumen, performed immediately after TBA, provided five major findings: (1) abrasion of the intima, (2) irregularity of the lumen due to poor expansion, (3) laceration of the wall, (4) mural thrombus and (5) calcification. The degree of each of these abnormalities was scored with a 3-grade scale (0, 1 and 2), and scores for the 5 abnormalities were totaled in each patient. Analysis of the relationship between scores and postoperative vascular patency demonstrated that patients without vascular patency in the early (within 6 months) or late period (6 months or more) after the operation had higher total scores as compared to those in whom the vessel remained patient in the corresponding postoperative periods (p less than 0.01, p less than 0.05). Among others, patients with a total score over 5 showed markedly lower patency rates in the early period (10%) as well as late period (0%) after the operation (p less than 0.01). These results indicate the usefulness of post-TBA angioscopic observation of vascular lumen in predicting the long-term patency of the vessels operated on.

Aged↗
PubMed1992

[Importance of sperm morphology assessment in human in vitro fertilization].

Two hundred eighteen IVF cycles were analyzed in order to clarify the influence of the strictly normal morphology (SNM) of sperm on IVF outcome. SNM was defined according to Kruger et al.'s strict criteria (1988) with our modifications. IVF cycles were divided into 3 groups: %SNM greater than or equal to 40% (69 cycles), 40% less than %SNM greater than or equal to 12% (123 cycles) and %SNM less than 12% (26 cycles). The rates of embryo transfer and pregnancy per cycle and the rate of abortion per pregnancy in the three groups were as follows: 81%, 39%, 19% in %SNM greater than or equal to 40%; 71%, 24%, 30% in 40% greater than %SNM greater than or equal to 12%; and 58%, 7.7%, 50% in %SNM less than 12%. The pregnancy rate per cycle significantly decreased as the %SNM decreased (p less than 0.01), and there was a tendency toward an increase in the abortion rate per pregnancy as the %SNM decreased. The results suggest that %SNM is a useful parameter to use in predicting the IVF outcome.

Abortion, Spontaneous↗
PubMed1992

[Effective high frequency jet ventilation setting for the preparation of internal thoracic artery for coronary artery bypass graft surgery].

Effective high frequency jet ventilation (HFJV) setting during the preparation of internal thoracic artery (ITA) was estimated in 35 patients who underwent coronary artery bypass graft (CABG) surgery. During ITA preparation, ventilation with the minimum lung movement without circulatory deterioration is necessary. Therefore, appropriate frequency, inspiratory time interval (Ti%) and working pressure (WP) for HFJV were investigated. Rising WP and prolonged Ti% provoked increasing tidal volume and decreasing PaCO2, whereas the lung extension disturbed the ITA preparation. By modifying the settings of frequency, Ti% and WP, we determined the frequency of 3Hz and Ti% of 50%. The correlation between WP at normocapnia and bodyweight (BW) is expressed in the following formula: WP = 0.16 x BW - 0.0003 (r = 0.72) Moreover satisfactory recording of end-tidal CO2 could not be obtained during HFJV. Therefore, we used transcutaneous CO2 (tc-CO2) analyzer. The coefficient between tc-CO2 and PaCO2 was 0.95, and tc-CO2 was useful as a non-invasive monitoring of PaCO2. There was little change in blood pressure, heart rate and cardiac output during HFJV. However mean pulmonary artery pressure (mPAP) increased significantly during hypercapnia especially when PaCO2 was over 50 mmHg. This suggests that mPAP may be more sensitive to PaCO2 compared with other circulatory parameters. HFJV with these settings produced good outcome for ventilation and circulation during the preparation of ITA.

Adolescent↗