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T Anzai

Publications and source records attributed to T Anzai.

At least 91 records · Page 5Linked to original sources
PubMed1992

[Clinical study of parathyroidectomy of secondary hyperparathyroidism in patients with chronic renal failure].

We performed parathyroidectomy for renal osteodystrophy due to secondary hyperparathyroidism on 16 patients with chronic renal failure who were refractory to medical management; subtotal parathyroidectomy on one patient and total parathyroidectomy with autotransplantation on 15 patients. Postoperative clinical improvement, i.e., bone and/or joint pain, pruritus and radiographic signs of renal osteodystrophy, was marked. After the operation, serum calcium decreased rapidly and adequate calcium replacement therapy was necessary. The levels of intact parathyroid hormone decreased rapidly and serum concentration of alkaline phosphatase gradually decreased for a few months postoperatively. Recurrence was diagnosed in one patient, who underwent excision of the transplanted parathyroid tissue. Osteomalasia due to hypoparathyroidism was not seen clinically in this series. In preoperative image diagnosis, ultrasonotomogram (US) showed the highest detective rate of the enlarged parathyroid glands. However, combination of US, computerized tomography and 99mTcO4(-)-201T1C1 scintigram can be recommended as a localizing diagnostic method for compensating the disadvantages of each method. Clinical results after parathyroidectomy for secondary hyperparathyroidism are considered to be good. However, long-term followup is mandatory for early detection of persistent hyperparathyroidism or hypoparathyroidism.

Adult↗
PubMed1991

The natural history and timing of the radical operation for subpulmonic ventricular septal defects.

In order to further understand the natural history and timing of repair for subpulmonic (type I) ventricular septal defect (VSD), 70 patients who underwent radical surgery were reviewed. The patients with this type of VSD accounted for 30 per cent of a total 236 children with types I, II and III VSD who underwent repair between 1978 and 1989. The frequency of aortic regurgitation was 30 per cent, being higher in the group aged older than 10 years than in the younger group (p less than 0.05). The median ages of patients with normal, prolapsed and regurgitated valves were 5, 6.5, and 10 years, respectively, and each value exhibited significant differences (p less than 0.05). The left to right shunt ratio and systolic pulmonary artery pressure of the patients with normal valves were significantly higher than those of the patients with abnormal valves. The outcome of the patients with regurgitation varied according to Sellers grading with cases of grade two valvular deformities recovering well after the repair, while cases of grade three had deformities of grade one or two severity remaining. These results led us to establish the following strategy for patients with I-VSD: 1) a child should be regularly checked by USG; 2) a child noted as having a prolapsing valve is recommended to undergo repair by the age of 10 to 12 years; and 3) a child found to have regurgitation should undergo repair as soon as possible, unless the valve regurgitation does not become more severe than Sellers grade two.

Adolescent↗
PubMed1991

[Ultrasonographic study on kidneys in patients with acute renal failure].

Ultrasonotomograms of 22 kidneys were obtained in 11 patients with renal-acute renal failure (renal-ARF). The underlying diseases of renal-ARF were acute tubular necrosis in 8 patients and acute on-set chronic glomerulonephritis in 3 patients. They were treated by hemodialysis in 10 patients and intermittent peritoneal dialysis in 1 patient. Ultrasonic measurement of the size of kidneys revealed that the thickness (anterior-posterior diameter) and the ratio of thickness to length (T/L) were greater in patients with ARF than in those with chronic renal failure and normal renal function. The patients with a low value of T/L (under 0.60) had a significantly greater urine volume than those with high a value of T/L (0.60 or more). The sonographic features of renal-ARF kidneys were marked increase in parenchymal echogenicity and appearance of hypoechoic swollen renal pyramids with sharpness of the corticomedullary border. In the course of ARF, these sonographic changes gradually disappeared when the patients had recovered from ARF. However, the prognosis was poor in patients with severer sonographic findings. We believe that repeated ultrasonic examination of the kidneys in patients with renal-ARF is useful for not only differential diagnosis of post-renal urinary obstruction but evaluating the course of ARF.

Acute Kidney Injury↗
PubMed1991

[Methicillin-cephem-resistant Staphylococcus aureus (MRSA) mediastinitis following open heart surgery].

Mediastinitis following cardiac surgery occurs frequently in association with high mortality and morbidity. Patient was a 6-year-old boy suffering from Sotos syndrome with secundum type of ASD. He was operated upon to repair ASD. Following the surgery, he suffered from MRSA mediastinitis and osteomyelitis of the sternum. Routine method of closed irrigation after reopening of the sternal wound was ineffective. Patient recovered following aggressive debridement repeatedly, open drainage and topical irrigation with vancomycin. This appears to be a useful method to treat MRSA mediastinitis of the sternum.

Cephalosporins↗
PubMed1991

[A case of peritonitis carcinomatosa due to advanced gastric cancer effectively treated by intraperitoneal injection of carboplatin].

The patient was a 72-year-old woman who had advanced carcinoma of the stomach. She presented massive ascites due to peritonitis carcinomatosa. The cytology of ascites was class V and the CEA level of ascites was elevated. Since renal function was low, we injected 300 mg of carboplatin intraperitoneally 2 times in 8 weeks. The amount of ascites was significantly diminished and the CEA level of ascites was decreased. The result suggested the effectiveness of intraperitoneal injection of carboplatin for the therapy of peritoneal metastasis of gastric cancer.

Aged↗
PubMed1991

[ARDS-like reactive respiratory failure after radical operation for esophageal cancer--with reference to PMN elastase and anaphylatoxin].

In a study undertaken to elucidate the pathophysiology underlying reactive respiratory failure following surgery for esophageal cancer, postoperative esophageal cancer patients were divided into 2 groups, i.e. one with respiratory failure (defined as impairment of oxygenating capacity with a respiratory index (RI) value of 1.5 or above, lasting from more than 5 days after surgery) and the other without it, and between-group comparisons were made of respiratory & circulatory dynamics and biologic response system components, e.g., complement, anaphylatoxins and polymorphonuclear granulocytes (PMN) elastase. There were no differences between the two groups in patient's age at operation and pulmonary function test. The mean duration of endotracheal control was 5.1 days for the respiratory failure (+) group against 3.7 days for the respiratory failure (-) group. Assessments of respiratory & circulatory dynamics showed that the RI was significantly increase early in the postoperative course in the respiratory failure (+) group as compared with the respiratory failure (-) group, while the hydrostatic pressure of pulmonary circulation (pulmonary microvascular pressure (Pmv)-plasma colloid-osmotic pressure (COP] and pulmonary shunting rate (Qs/Qt) were also elevated in the former group. Among biologic response parameters, the leukocyte count, platelet count, CH5, C3, and C5 showed long-sustained decreases from the postoperative day 1 on in the repertory failure (+) group as compared to the respiratory failure (-) while PMN elastase activity and anaphylatoxin C3a were elevated from the postoperative day 1 on in the former group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

[Effects of dopamine and dobutamine on systemic hemodynamics and myocardial metabolism in children after open heart surgery].

The purpose of this study is to know the effects of Dopamine (DOA) and Dobutamine (DOB) on the systemic hemodynamics and myocardial metabolism in the acute phase after open heart surgery in children. Thirty patients with congenital heart disease were divided into following two groups. The first 14 cases were administered 5 and 10 micrograms/kg/min (gamma) of DOA, and the systemic hemodynamic and metabolic data were taken before and after the administration of the drug. The second 12 cases were given the same doses of DOB instead of DOA. DOA: The blood pressure was elevated by 10 gamma of DOA, and cardiac index (CI) and stroke volume index (SVI) rose up at both doses of DOA. On the other hand, systemic vascular resistance (SVR) and left atrial pressure (LAP) were decreased at both dosage levels. DOB: At the same dose of DOA, DOB increased HR and SVI, so CI rose up markedly. The systolic and mean blood pressure also rose up at both doses. CVP and LAP were depressed at either dosage level. SVR did not show an appreciable change. Myocardial metabolism: The two drugs tested did not exhibit the progress of anaerobic myocardial metabolism. The myocardial oxygen uptake rate increased with DOA, but decreased with DOB. This phenomena probably suggests that DOB dilates coronary vascular bed. From the above data, the following effects are expected by the use of each drug after open heart surgery in children: 1) an increase of cardiac output due to inotropic action by DOA, 2) powerful inotropic and chronotropic action by DOB.

Child↗
PubMed1990

[Changes in lipase activity during pregnancy and lactation in the mouse mammary gland].

Mammary gland lipase activity of the mouse increased 45-fold compared to that in unmated gland at the 15th day of pregnancy and was 65-fold at the 20th day of pregnancy. After parturition, the activity abruptly decreased during 3 days to 38% of that at the 20th day of pregnancy. On the other hand, only a very small lipoprotein lipase activity was observed in the pregnant gland, the activity increased to 15-fold that of 20 day pregnancy at the 3rd day of lactation. These facts suggest that the mammary epithelial cells (mammary gland lipase activity was detected only in epithelial cells) utilize the fat reserved in the gland during pregnancy, but the lactating mammary epithelial cells utilize the fat supplied from the blood circulation. Mammary gland lipase activity was decreased by treatment with epinephrine which increased the fat mobilization in other adipose tissues. Hydrocortisone and prolactin decreased the mammary gland lipase activity in the glands of pregnancy and lactation. In addition, no hormone-sensitive lipase activity was observed in the mammary gland. Thus, the control of fat mobilization in the mammary gland must be different from that in other adipose tissues.

Animals↗
PubMed1990

The activation of phosphatidylinositol-specific phospholipase C by insulin in mammary epithelial cells of lactating mouse.

We have previously demonstrated in vitro that, in the endoplasmic reticulum and Golgi apparatus of mammary epithelial cells of lactating and pregnant mice, inositol 1,4,5-trisphosphate releases Ca2+ that has been stored in these organelles. In this study, we examined whether insulin and prolactin, essential for the growth of mammary gland and for lactation, influenced the activity of phosphatidylinositol-specific phospholipase C in mammary cells. In the plasma membrane fraction of mammary epithelial cells of the DDY mouse strain 5 days after the start of lactation after the first pregnancy, and with phosphatidylinositol as substrate, it was shown that the activity of phospholipase C was enhanced by about four times in the presence of insulin compared with the control. Such enhancement was not found in the membrane fraction treated with prolactin.

Animals↗
PubMed1990

Effects of inositol 1,4,5-trisphosphate on calcium release from the endoplasmic reticulum and Golgi apparatus in mouse mammary epithelial cells: a comparison during pregnancy and lactation.

It has been established that inositol 1,4,5-trisphosphate(IP3) is responsible for the mobilization of calcium(Ca2+) from intracellular locations in a wide variety of tissues, and that this response triggers the stimulation of several hormones and neurotransmitters. However, these phenomena have yet to be examined in the mammary epithelium. Ca2+ uptake from the medium into the endoplasmic reticulum(ER) and Golgi apparatus in vitro in both pregnant and lactating mouse mammary epithelial cells was studied and a strong Ca2+ release from these organelles into the medium with the use of IP3 was shown. The Ca2+ uptake and its release due to IP3 was also usually greater during pregnancy than lactation.

Animals↗
PubMed1990

Inner ear impairment following combined CDDP (platinum preparation) and radiation therapy.

Hearing ability was examined in patients with head and neck cancer treated by combined CDDP and electron beam therapy. In 3 of 7 patients with maxillary cancer, hearing impairment apparently attributable to the therapy was noted on the affected side. In one of these 3 patients, the temporal bone was observed, but the cause of hearing impairment could not be determined. We present patients with cancer of the external ear in whom radiation-caused hearing impairment worsened probably due to combined CDDP and electron beam therapy.

Adult↗
PubMed1990

Temporal bone findings in two cases of head injury.

Temporal bone findings in two cases of head injury are reported. In one patient, longitudinal fractures occurred in both temporal bones, and extended to the middle ear bilaterally. Bleeding was seen in the tympanic cavity, mastoid air cells, internal auditory meatus and facial nerve canal. Bleeding was observed in the scala tympani, cochlear aqueduct and endolymphatic sac, but there were no fractures. In the other patient, bleeding was seen in the internal auditory meatus and facial nerve canal. In the right ear, endolymphatic hydrops was observed in all turns of the cochlea.

Adult↗
PubMed1990

Disseminated coccidioidomycosis.

We report a case of disseminated coccidioidomycosis in a 39-year-old Japanese male whose illness developed after returning from a trip to an endemic area. He showed positive coccidioidin skin reaction throughout the entire course of his illness. The primary lesion in the lung subsequently spread to the bone. While the patient was on treatment with 5-FC, he made another trip to the same endemic area. After this episode, he developed pulmonary symptoms and cutaneous nodules on his wrist. The possibility of reinfection with Coccidioides immitis is discussed. Electron microscopy of the cutaneous nodules revealed that the spherules examined maintained their structural integrity in the granulomatous lesion, suggesting the high viability of the organism. Host-parasitic interaction in coccidioidomycosis is discussed.

Adult↗
PubMed1990

[Ultrasonographic study on kidneys in patients with chronic renal failure. Part I. Ultrasonic measurement of renal size and analysis of renal ultrasonotomograms].

Ultrasonograms of 546 kidneys were obtained in 280 patients undergoing chronic dialysis. Dialysed kidneys could be detected in 529 of the 546 kidneys (96.9%) by ultrasonic examination. The ultrasonic diagnoses on dialysed kidneys were contracted kidney in 313 kidneys (59.2%) and acquired cystic disease of the kidney in 107 kidneys (20.2%). Ultrasonic measurement of the size of kidney (length and thickness) revealed that the kidneys in patients with chronic renal failure were much smaller than normal ones. But the kidneys in patients undergoing dialysis for more than 8 years gradually increased in size with incidence of acquired renal cysts. The kidneys in patients with diabetic nephropathy were greater in length and thickness than those with chronic glomerulonephritis. Sonographic features of dialysed kidneys were unclear renal imaging, unidentified central echoes, cortico-medulla + border and increased parenchymal echogenicity. Irregularity of the renal contour had a tendency to increase in number with incidence of cysts in long-term dialysis patients. The ultrasonograms of the kidneys with diabetic nephropathy showed fewer changes than normal ones. No major complication of the kidney was detected in the present study. However, two retroperitoneal hematomas and one renal cell carcinoma developed within two years after this examination. We believe that regular screening of the kidneys by ultrasonic examination is mandatory in patients on chronic dialysis for early diagnosis and treatment of these complications.

Adolescent↗
PubMed1990

[Ultrasonographic study on kidneys in patients with chronic renal failure. Part II. Acquired cystic disease of the kidneys].

Ultrasonic examination of the kidney was performed on 280 patients undergoing chronic dialysis. Acquired cystic disease of the kidney (ACDK) was detected in 107 of 529 kidneys (20.2%). This paper presents an analysis of ultrasonotomograms of ACDK. Ultrasonic measurement of the size of ACDK was 72.5 +/- 15.2 mm in length and 41.7 +/- 9.8 mm in thickness. The size of ACDK was significantly greater than that of contracted kidneys by ultrasonographic diagnosis. With regard to sex distinction the length and thickness of ACDK were significantly greater in males than in females. As for laboratory data, patients with ACDK showed significantly higher values of red blood cell count, hematocrit and serum creatinine concentration compared with contracted kidneys. Prolongation of the dialysis peirod increased the incidence of ACDK. The size of ACDK showed a tendency to increase with duration of dialysis. However, no correlation was noted statistically between the incidence of ACDK and duration of dialysis and between the size of ACDK and duration of dialysis. There was a significantly lower incidence of ACDK in patients with diabetic nephropathy than those with chronic glomerulonephritis. A sonographic feature of ACDK is irregularity of the renal contour because of cystic transformation. Renal imaging, identification of the corticomedullary border, identification of the central echoes and increased parenchymal echogenicity were similar to other dialyzed kidneys. The main complications of ACDK are hemorrhage and tumor formation. We observed two retroperitoneal hematomas and one renal cell carcinoma developed within two years after this examination. The incidence of complications of ACDK was 5.1 per cent. We believe that patients with ACDK should be watched carefully by regular ultrasonic examination for early diagnosis and treatment of these complications.

Adult↗
PubMed1990

Muscle regeneration and cell-mediated cytotoxicity in the autologous muscle culture of dermatomyositis.

Muscle culture from a dermatomyositis patient was performed to investigate the muscle regeneration and cell-mediated cytotoxicity. In the primary culture, spindle-shaped mononuclear myoblasts exponentially increased in number. In the secondary culture, the myotubes fused with the myoblasts and/or other myotubes into large thick syncytia. The cell morphology and growth pattern of the cultured muscle cells in dermatomyositis were identical to those of normal healthy controls. The autologous mononuclear cells added in the secondary culture of day 14 adhered to the surface membrane of the myotubes. Three days after this treatment, the myotubes underwent degenerative changes. On the other hand, in two series of sister cultures, each added with the autologous serum and control medium, no remarkable morphological changes were observed. The results of the present study suggest that dermatomyositis could be precipitated by the associated abnormal cell-mediated cytotoxicity, but not by abnormalities in muscle fibers per se.

Aged↗