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Biomedical subjects

S Mizumoto

Publications and source records attributed to S Mizumoto.

At least 19 recordsLinked to original sources
PubMed1992

Continuous local intraarterial infusion after prolonged arterial stasis in the fingers and toes.

Seven patients with trauma to eight digits and one toe went untreated for arterial stasis, with subsequent development of posttraumatic changes in skin coloration. In two patients involving two digits, a daily dose of 2,000 ml containing 240,000 U urokinase, 80 micrograms prostaglandin E1, and 10,000 U heparin in lactated Ringer's solution was administered by intravenous infusion for 10 consecutive days; one of the two digits became necrotic. In all subsequent patients, a daily dose of 80 ml containing 240,000 U urokinase, 40 micrograms prostaglandin E1, 10,000 U (maximum) heparin, and low-molecular-weight dextran was administered by continuous local intraarterial infusion for 10 consecutive days. These seven extremities survived, even in the case of two digits and one toe with over 50 hr of arterial stasis. We believe that revascularization of extremities following prolonged periods of arterial stasis may be possible by means of continuous local intraarterial infusion of antithrombotic agents.

Aged↗
PubMed1992

Vascularized fibular graft for reconstruction after resection of aggressive benign and malignant bone tumors.

From 1982 to 1991, 19 patients at Nara Medical University, Kashihara, Japan, underwent resection of aggressive benign and malignant bone tumors, with limb salvage and reconstruction by free vascularized fibula grafts. The patients were followed up for an average of 54 months. The reconstructed site was the jaw in 6 cases, upper extremity in 3, spine in 1, pelvis in 2, and lower extremity in 7. Six patients had aggressive benign lesions, and 13 had malignant lesions. The sizes of the resultant bone defect ranged from 6 to 20 cm, and the lengths of fibular used ranged from 8 to 24 cm. The average time to union was 4.1 months (2-9 months) in the extremities and pelvis. Local recurrence was observed in 3 cases, for whom vascularized fibula grafts were performed for recurrent tumors. In cases of primary untreated tumors, no recurrences occurred. Therefore, this procedure should be performed at the time of primary operation after extensive resection of an aggressive benign or malignant bone tumor.

Adolescent↗
PubMed1992

Pre-formed vascularized bone grafts using polyethelyne chambers.

Previous work has shown that corticocancellous bone chips placed in a titanium chamber with an arteriovenous vascular pedicle will result in a pre-formed vascularized bone graft. The present study was designed to determine whether these grafts can be transferred as an island or free vascularized bone graft, and to examine the material properties of these grafts. Thirty-two male, New Zealand white rabbits were divided into four groups based on the time of sacrifice following the initial chamber implantation. Injected molded cylindrical polyethelyne chambers, measuring 22 mm long and with an 8-mm inner diameter, were used. Corticocancellous bone chips were placed in the chambers and each chamber was implanted in the mid-thigh, with saphenous vessels running through the chamber. The chambers were implanted into the right and left thigh of each animal. To test the hypothesis of the possibility of transferring this graft as an island or free vascularized graft, ligation of the distal vascular pedicle on one side was achieved at re-exploration at 3, 6, 9, and 12 weeks. The contralateral side served as a control in which the vascular pedicle was not ligated. In the controls, bony bridging between the corticocancellous bone chips was observed after 7 weeks. A solid bone graft was present within the chamber by 10 weeks. However, histomorphometric evaluation indicated significant bone resorption. By 13 weeks, resorption progressed to the point where only small islands of bone remained. Ligation of the distal vessels resulted in thrombosis of the vessels within the chamber. Necrosis of newly-formed bone was observed in the area adjacent to the vascular thrombosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1992

[Evaluation of endoscopic mucosal resection (EMR) as a curative therapy against early gastric cancer].

This study investigated the effectiveness of EMR as a curative therapy against early gastric cancer, comparing with that of radical operation. In 256 radical operation cases, five year survival rates were 97.5% in m-cancer and 93.2% in sm-cancer. In these cases, postoperative complications occurred in 7.8%, with operative mortality being 0.78%. In 56 EMR cases, nine encountered slight bleeding, which was controlled by ethanol injection under endoscopy. Regarding prognosis of EMR, cancer recurrences occurred in 45.8% of cases with stump involvement in the resected mucosa (stump (+)). In cases without stump involvement in the resected mucosa (stump (-)), no recurrence were found except one case, in which distance from the cancer edge to the stump was only 0.6 mm, suggesting that enough distance (2mm) to the stump is required for curative EMR. Stump (-) rate was high (81.2%) in cases of small cancer less than 1 cm in diameter, but was low in cases of cancer greater than 2 cm and those located in upper body or lesser curvature. To establish EMR as a curative therapy, it must be performed by single collection to check remaining cancer. In conclusion, although radical operation is still the standard curative therapy, EMR should be considered as an alternative therapy.

Aged↗
PubMed1992

[A histopathological study on the femoral head necrosis in spontaneously hypertensive rats (SHR)].

The histopathological study was conducted in the femoral head of spontaneously hypertensive rats (SHR), which had frequently manifested osteonecrosis and a delay in the ossification at the femoral epiphysis. In order to elucidate the course of necrosis and its repair process, the bone dynamic of the femoral head was investigated with bone fluorochrome labelling technique. Femoral epiphyses in the SHR were classified into five groups, according to their histopathological changes in relation to osteonecrosis, its repair process and the delay in ossification. Changes in the growing rate of the growth plate at the femoral head and neck were measured quantitatively. As a result, the articular cartilage remained viable and overgrowing, while the epiphyseal plates were affected by the necrosis and there was early physeal maturation occurred. It is concluded that SHR appear to be a useful experimental model for Perthes' disease.

Animals↗
PubMed1991

Continuous local intra-arterial infusion of antithrombotic agents for replantation (comparison with intravenous infusion).

The success rate of replantation of amputated digits and limbs appears to be improved by local continuous intra-arterial infusion of urokinases, heparin and PGE1 at a daily dose of 240,000 I.U., 10,000 U, and 40 micrograms, respectively, for ten days, in comparison to intravenous infusion of the drugs. The purpose of this study was to investigate the difference between the haematological effects of intra-arterial and intravenous infusion. Accordingly coagulation and fibrinolytic enzyme levels were examined before, and at 4 and 12 hours after the start of infusion and on the 3rd and 10th postoperative days. Intra-arterial infusion was advantageous over intravenous infusion probably because the effect of general metabolism on drug levels was small, drugs exhibited immediate action and efficacy was localised. No particular side effects were demonstrated.

Blood Coagulation Factors↗
PubMed1991

[Effect of gastrectomy on release of gut hormones].

We investigated the effect of gastrectomy on the digestive system in 87 postoperative long-term survivors under test meal or egg yolk load. After test meal, gastrin and secretin responses were decreased in each of groups of proximal gastrectomy (PG), distal gastrectomy with Billroth-I (DG-B1), that with Billroth-II (DG-B2), total gastrectomy with interposition (TG-I), and that with Roux-Y (TG-RY). However, sufficient acid-secretors after partial gastrectomy showed secretin responses comparable to controls. Furthermore, cases of total gastrectomy given betain-hydrochloride with test meal increased secretin responses. Serum glucose response was higher in the TG-RY group while insulin response was high in the TG-RY and DG-B2 groups, compared with controls. GLI response was high in all groups compared with controls. Postgastrectomy gallstone occurred in 11.6%. Yolk-induced contraction of the gallbladder was decreased, and CCK release increased, for several years postoperatively. Gallbladder contraction with CCK was reduced for one year postoperatively. The contraction was reduced in persons with gallstone than those without it. This study shows that the digestive function after gastrectomy depends on acidification and duodenal passage of food, and that reduced contraction with CCK plays an important role in hypokinesis of the gallbladder.

Animals↗
PubMed1990

An experimental study of the venous flap: investigation of the recipient vein.

In previous studies using rabbit ears, total venous perfusion flaps (TVPF) were used that did not contain in the experimental model any chosen arteries truly representative of clinical venous flaps. We discovered that the TVPF could survive even under conditions of poor blood circulation. In the present study, conditions of the recipient veins were investigated using flow-through veins in TVPFs of rabbit ears and human dorsal digital veins. The research suggested that conditions for TVPF survival are a high density of the venous network in the flap and the presence of venous oscillation, high oxygen tension, and effective blood flow in the recipient vein.

Adolescent↗
PubMed1990

Continuous local intraarterial infusion of antithrombotic agents for epigastric flap transfer in rabbit.

In free tissue transfer, the recipient arteries and veins are often damaged by injury, and their lumens are often narrowed due to thickening of the intima. These factors are considered paramount in the poor success rate of free tissue transfers. In the reported study, the authors examined the effects of continuous intraarterial infusion with heparin and urokinase in experimental epigastric flap transfer. By intraarterial infusion, the drug concentration at the target site could be significantly increased. The viability of an epigastric flap transferred to a recipient site with thickened arterial intima was significantly improved in a rabbit model by a seven-day continuous local intraarterial infusion of heparin at 10 U/kg/hr and urokinase at 100 IU/kg/hr, compared with control or intravenous infusion. Use of an anticoagulant with a fibrinolytic enzyme is considered to be the best choice for a successful outcome in flap transfer.

Abdomen↗
PubMed1990

Treatment of hepatocellular carcinoma by segmental hepatic artery injection of adriamycin-in-oil emulsion with overflow to segmental portal veins.

Hepatocellular carcinoma was treated with slow injection of an emulsion containing 40 to 60 mg of adriamycin and 3.5 to 12 ml of Lipiodol into the portal vein via a segmental hepatic artery. During and after the injection, the portal branches of the segment were demonstrated. Six patients with resectable hepatocellular carcinoma received this treatment, which in 3 of them was followed by embolization with Gelfoam of the segmental artery. In these 3, all main tumors and daughter nodules became completely necrotic, but some infarction developed in the non-tumorous area. Those without Gelfoam had complete necrosis of all daughter nodules, but incomplete response of the main tumor. This combined treatment may be recommended for patients with localized lesions which are nonresectable due to cirrhosis, or for other reasons.

Aged↗
PubMed1990

[A case report on the repair of an anterior mitral leaflet chordal rupture using PTFE suture].

Surgical repair of ruptured or elongated chordae tendineae of the mitral valve is one of the most complex reconstructive techniques in cardiac surgery. Various surgical procedures have been described to repair chordal abnormalities of the anterior leaflet of the mitral valve. This case report describes a simple repair technique with a double-armed, pledge-supported, expanded polytetrafluorethylene (PTFE) suture. A 48 year-old-man who had mitral regurgitation due to ruptured chordae tendineae of the anterior mitral leaflet underwent successful chordal reconstruction using 3--0 PTFE suture. Mitral regurgitation was completely repaired as shown by left ventriculogram and echo cardiogram more than one year postoperatively. In this experience, this procedure could be used to treat both elongated and ruptured chordae tendineae.

Chordae Tendineae↗
PubMed1989

Treatment of skin and median nerve defects with peroneal neurofasciocutaneous flap.

A large neurofasciocutaneous flap that consisted of a peroneal flap and a segment of sural nerve was used in the simultaneous reconstruction of a large soft tissue and nerve defect caused by a crushing injury of the distal forearm. A 10 x 15 cm peroneal flap, including a 10 cm segment of sural nerve, was successfully transferred to an 8 x 12 cm skin defect, reconstructing a 5 cm defect of the median nerve. Two years after repair, the opponens pollicis muscle showed good contraction, although palmar abduction of the thumb remained poor. Static two-point discrimination was 20 mm on the pulp surface of both thumb and index finger and 15 mm on the middle finger.

Adult↗
PubMed1989

Continuous local intra-arterial infusion of anticoagulants for digit replantation and treatment of damaged arteries.

From May 1958 to May 1987, 428 upper extremities were replanted, with an overall survival rate of 87.4 percent. With the aim of increasing the survival rate a new method was tried. Unlike conventional continuous intravenous infusion, a Teflon catheter (28 gauge) was inserted into the proximal main artery of the anastomosed artery, and a daily dose of 80 ml comprising 240,000 U of urokinase, 40 micrograms of prostaglandin E1, 10,000 U (maximum) of heparin, and low molecular weight dextran was administered by means of continuous infusion for the 10 consecutive days, during which arterial thrombosis is likely to occur. Thirteen cases (replantations and damaged digital arteries) survived without any re-operation for arterial thrombus. There were statistically significant differences (p less than 0.025) in platelet count, fibrinogen, and AT III preoperatively and three days postoperatively. There were also statistically significant differences (p less than 0.05) in prothrombin time, partial thromboplastin time, and clotting time between pre-operative measurements and those taken four and 15 hr postoperative, but those data remained within normal range. No abnormalities were present in the arteries through which the catheter was inserted, as validated by postoperative digital subtraction angiography.

Adult↗
PubMed1989

Pedicled and "flow-through" venous flaps: clinical applications.

Recently, the pedicled venous flap and "flow-through" venous flap have been the focus of increasing attention for skin defects of the fingers and hands. For successful venous flap use, the following approaches have been suggested: (1) a pedicled venous flap with preservation of the draining veins alone; (2) a "flow-through" flap with preservation of a flow-through vein in the flap; and (3) an arterialized "flow-through" venous flap which ensures arterial blood flow into the flap. Based on findings that venous blood is helpful in flap survival, the authors made use of the first two flap types, the pedicled venous flap and the "flow-through" venous flap and attempted to establish and clarify reasonable conditions for flap survival. Venous pressure of the finger and elbow was measured and venographies of the finger and hand were also carried out. The following conditions are regarded as essential in successful venous flap procedures: (a) use of a venous flap with a rich venous network; (b) preservation of many "flow-through" veins; (c) harvesting a pedicled venous flap where the veins have afferent (reversed) venous pressure; and (d) anastomosing veins of the "flow-through" flap with recipient veins where high efferent venous pressure exists and differential pressure is observed. Clinical cases are presented and the authors attempt to explain flap failure from previously unknown causes. Conditions for flap harvesting are also discussed.

Adult↗
PubMed1989

[An autopsied case of an aged patient with advanced gastric cancer that showed a complete response to immunochemotherapy].

Described is the case of an 88-year-old male suffering from advanced hemorrhagic gastric cancer who, because of surgical risk factors, was conservatively treated with immuno-chemotherapy in the form of suppositories containing ftorafur (FT-207) and Picibanil (OK-432). The patient showed marked clinical improvement from this therapy. However, his advanced age and other associated complications kept us from performing further examinations, such as an upper-G-I series and a gastrofiberscopy. A year and 4-months later, the patients died of pneumonia and subsequently was autopsied. Macroscopically, his gastric tumor was found to have completely disappeared and had been replaced by a yellowish-white scar tissue. Microscopically, no cancer cells were found in the examined specimens or in the regional lymph nodes.

Adenocarcinoma↗
PubMed1989

[Limitation of oily chemoembolization against hepatocellular carcinoma and arterioportal segmental chemoembolization].

Emulsion of adriamycin and lipiodol added with Gelfoam has been used for the transcatheter oily chemoembolization against hepatocellular carcinomas. This therapy resulted in significantly increased cumulative survival as compared with chemoembolization therapy using anti-cancer drugs and Gelfoam. However, it was revealed to have the following limitations: Insufficient efficacy against micrometastases and extracapsular invasion; impossible to perform sufficient treatment for patients with severe hepatic disorders; and there were cases in which lipiodol was hardly retained. In order to overcome the limitations described above, we have performed segmental hepatic chemoembolization simultaneously from the hepatic artery embolization simultaneously from the hepatic artery and portal vein. This method works on the basis of the fact that excess amount of lipiodol emulsion infused from the hepatic artery flows into the portal vein. Gelfoam embolization is also added in this method. Though subjects appropriate for this newly developed method are restricted, all the tumors in the objective segment of the liver can undergo necrosis. The efficacy is comparable to the effects of hepatectomy. In addition, since the other segments of the liver are able to be kept in reserve, this method is able to be applied to patients with severe hepatic disorders.

Aged↗
PubMed1989

[Endoscopic hemostasis against hemorrhage from the upper gastrointestinal tract: its indication and limitation].

We reviewed endoscopic hemostasis that had been performed upon 353 acutely hemorrhagic peptic ulcer cases: Among them, 145 received thrombin spraying; 36, electrocoagulation; 145, topical injection of ethanol; and 27, topical injection of aetoxyscrelol. Hemostasis lasting for more than 24 hours after the treatment was defined as transient hemostasis, and hemostasis lasting for more than two weeks, as permanent hemostasis. The overall rate of transient hemostasis was 87.5%; 84.8% by thrombin spraying, 83.4% by electrocoagulation, 89.0% by injection of ethanol, 100% by injection of aetoxyscrelol, respectively. The overall rate of permanent hemostasis was 71.1%; 75.9% by thrombin spraying, 58.3% by electrocoagulation, 69.7% by injection of ethanol, 70.4% by injection of aetoxyscrelol, respectively. The rate of emergency operation for bleeding was reduced to 9.9% after the induction of endoscopic hemostasis from 64.0% before the induction. The mortality was also reduced to 3.1% from 8.9%. Particularly, over the last 4 years, the emergency operation and the mortality have been reduced, accounting from 7.2% and 2.2%, respectively. In conclusions, thrombin spraying is the first choice for mild and diffuse hemorrhage, and topical injection of ethanol is indicated for hemorrhage from exposed vessels and for localized hemorrhage.

Aged↗