Biomedical subjects
Publications and source records attributed to T Satou.
We describe the MR appearance of the persistent hypoglossal artery incidentally found in a case of known glioblastoma multiforme. On the spin-echo images, an abnormal tubular structure of low intensity penetrating the hypoglossal canal was recognized. MR angiography showed its vascular nature and the anomalous vessel connecting the internal carotid and basilar arteries.
Irinotecan (CPT-11) is a camptothecine derivative with antitumor activity and inhibitor of DNA topoisomerase I. CPT-11 showed a excellent and broad anticancer activity against several malignant tumors. In this study, as in the Japanese phase II study, CPT-11 was administered at 100 mg/m2 weekly by intravenous infusion against 10 patients with recurrent colorectal cancer. Median total dose was 513 mg. Partial responses were obtained in 4/10 patient (40%). Lung metastases showed a 33.3% response and lymphnode metastases showed a 60% response. However, liver metastases showed no response. The median duration to the onset of partial response was 20 days and the median overall response duration was 89 days. Adverse effects were leukopenia (40%), nausea, vomiting and diarrhea (80%), fever (20%), and general malaise (30%). These were generally well tolerated and reversible. From these results, CPT-11 seemed to become an effective drug for recurrent colorectal cancer. Further trials of combination chemotherapy utilizing CPT-11 seem to be warranted.
We treated a patient with a complete invagination of the cecum that contained two large laminated calcified fecaliths. Colonofiberscopy showed a dimpling submucosal tumor that was palpated as a bony hard tumor at laparotomy. This finding suggested that the fecaliths caused intussusception of the cecum and that such an intussusception should be suspected when a bony hard, dimpling submucosal tumor is found in the cecum. To our knowledge, this is the first reported case of a cecal invagination accompanied by calcified fecaliths without an appendical intussusception.
In the last few years, epidemiological studies have shown correlations between the low endurance capacity of the erector spinae muscle and low back pain (LBP). In this study, the function of the erector spinae muscle and localized muscle fatigue in LBP were investigated in both LBP patients and control subjects without LBP, using surface multi-channel electromyograms (EMG). Four positions (L1, L2, L4, L5) were chosen as representative locations for the different functions of the erector spinae muscle. Median frequency (fm) parameters of an EMG power density spectrum were monitored to quantify localized muscle fatigue. This research indicated a statistically significant difference (P < 0.05) in fm parameters between the LBP patients and the control subjects. The integrated electromyogram (iEMG) signals of LBP patients were considerably higher than for the control subjects during endurance isometric contraction. Our research suggested that human fatiguing erector spinae muscle, in submaximal voluntary contractions tests, induced a different firing order of motor unit spikes between two groups.
A 13-year-old boy without any previous illness was diagnosed as suffering from acute lymphoblastic leukemia (ALL). After a period of apparent complete remission until 17 years of age, the presence of Ph1 positive cells in bone marrow was demonstrated by karyotype analysis. This finding suggested chronic myelogenous leukemia (CML) because of the absence of blastic changes in bone marrow but mild leukocytosis with basophilia at that time. Six months later he had a relapse (blast crisis) with the appearance of peroxidase negative lymphoid blasts and myeloid surface markers. To make differential diagnosis, leukemia blasts at onset and relapse were examined for rearrangement of immunoglobulin JH gene and bcr/abl fusion mRNA, and were found to have the same JH gene rearrangement pattern and the same bcr/abl mRNA of bcr exon 2/abl exon 2. These results indicate an unusual case of CML which appeared in blast crisis at onset, followed by a long-term remission.
Emergency coronary artery bypass grafting was performed in a 61 year old man who developed acute severe cardiac and respiratory dysfunction after myocardial infarction. At operation cardiac arrest was obtained by warm blood cardioplegia in antegrade intermittent fashion. The left anterior descending artery, diagonal branch, and right coronary artery were revascularized by saphenous vein (SVG). After declamping the aorta, spontaneous heart beating was obtained and postoperative course was uneventful. Postoperative examination showed patent all SVGs and improved cardiac function. Although the delivery of the warm blood cardioplegia was controversial, our recent study revealed that the intermittent antegrade delivery of warm blood cardioplegia showed no ischemic changes of the heart during the procedure.
Since 1984, 1410 patients underwent coronary bypass grafting at Juntendo University Hospital. At the primary operation 797 patients had internal thoracic artery (ITA) graft and 613 patients received only saphenous vein graft (SVG). Reoperation was done in one pt. in ITA group and 10 pts. in SVG group. There were 2 deaths (reoperative mortality 18%). Percutaneous Transluminal Coronary Angioplasty to stenotic SVG was applied to 71 lesions in CABG patients. The primary success rate was 81.7% and restenosis rate was 38.9%. Urgent reoperation was performed on 3 pts. who had PTCA to diseased LAD or stenotic SVG to LAD. Reoperation is technically demanding and is associated with high mortality. Balloon angioplasty may provide a suitable alternative. But high restenosis rate (especially acute stenosis) remains a significant problem, particularly in the pts. with diseased LAD or stenotic vein graft to LAD. Reoperation is another option to relieve the ischemic symptoms in pts. with diseased LAD or stenotic vein graft to LAD.
We report a case of cytomegalovirus infection of the seminal vesicle and ductus deferens in a 32-year-old Japanese man with papillary adenocarcinoma of the lung. Although the lungs are usually a target organ of cytomegalovirus infection, most organs can be involved. However, the male reproductive system has rarely been reported infected with the virus. H.E. sections of our case showed cytomegaloviral inclusions in many ductal epithelia of the seminal vesicle and ductus deferens as well as macrophages of the lungs. Immunohistochemistry using monoclonal antibody to cytomegalovirus disclosed viral antigenicity in these infected cells. Electron microscopy recovered enlarged infected cells packed with viral nucleocapsids approximately 100 nm in size. These nucleocapsids were enveloped in the cytoplasm and consistent with the Herpesviridae family. To our knowledge, our case is the first report of cytomegalovirus infection of the seminal vesicle and ductus deferens in the English and Japanese literature.
Warmed (47 degrees C) 5 to 10% glucose solution with the addition of 0.05 mg of noradrenaline (PTCT) was administered after chemotherapy (MMC 2-10 mg or CDDP 10 mg) into tumor feeding artery of liver tumors (17 cases) and pancreas tumors (8 cases). Efficacy was noted in 14 cases with liver tumor (14/17 82.3%) and in 4 cases with pancreas tumor (4/8 50%). The metastatic rate in the PTCT with systemic administration of pyrimidine (5-FU: 100-300 mg or FT-207: 1,000 mg) was 0% (0/10) compared with 45.5% in controls (5/11) (p = 0.023). Thus, systemic administration of 5-FU or FT-207 after thermochemotherapy can prevent distant metastasis.
The clinical courses of 9 patients with acquired immunodeficiency syndrome (AIDS) complicated by pneumocystis carinii pneumonia (PCP) were followed to investigate the clinical significance of the measurement of various parameters such as serum lactate dehydrogenase (LDH). The mean duration of symptoms before diagnosis was 20 days, and the median duration of therapy was 29.5 days. Serum LDH activity increased in 8 of 9 cases. The isozyme pattern in all cases was characterized by high LDH3 values from the early stage. However, inflammatory markers did not increase in most cases. There were good correlations between the levels of LDH, clinical course, and PaO2.
1. Experimental Study. Walker-256 (5 x 10(7) cells, which were resistant to hyperthermia, were implanted into the dorsal hind paw of Wistar rats. Warmed (37 degrees C or 40 degrees C) physiological saline using 0.05% of noradrenaline injected into the tumor feeding artery (PTCT) after chemotherapy in D-4 and D-8 groups. (When tumor cells were implanted 4 days before in D-4 group and the tumor vessels were not formed. In D-8 group, when implanted 8 days before, many tumor vessels were observed.) The tumor growth curve at 6 days after treatment by PTCT (40 degrees C) and chemotherapy was inhibited in the D-8 group, not in the D-4 group. The tumor blood flow rate was about 80% impaired compared with the controls at 60 minutes. Microcirculatory disturbance of the tumor vessels was found in 6 (12) hours after PTCT and chemotherapy, even though the temperature of the tumor tissue was no more than 32 degrees C. 2. Clinical study. Warmed (47 degrees C) 5% glucose solution with addition of 0.05 mg of noradrenaline (PTCT) after chemotherapy (MMC: 6-10 mg, or CDDP: 10 mg) was administered into the tumor feeding artery of liver tumor (7 cases), pancreas tumor (4 cases), gall bladder tumor (2 cases) and metastatic bone tumor (1 case) with 80% (12/15) PR.
C. trachomatis antigen in first-voided urine sediments was detected by a new EIA kit using a monoclonal antibody, IDEIA CHLAMYDIA (IDEIA, Novo Nordisk), in males with urethritis and females with cervicitis. The result was compared with that by Chlamydiazyme (Abbott). 1. C. trachomatis antigen detection in male urethritis (285 cases) by the IDEIA test: The antigen detection rate was 37.9% (108/285) in urethral smears, and 33.7% (96/285) in first-voided urine sediments of the patients. The positive co-incidence rate between urethral smears and first-voided urine sediments was 82.4% (98/108). Thus, the detection of the antigen seems feasible in first-voided urine sediments. 2. Comparison of C. trachomatis antigen detection by the IDEIA and Chlamydiazyme tests: In 78 male cases with urethritis undergoing both tests, the rates of antigen detection from urethral smears and first-voided urine sediments were studied. The detection rate from urethral smears was 41.0% (32/78) for IDEIA, and 37.2% (29/78) for Chlamydiazyme. In first-voided urine sediments, the rate was 35.9% (28/78) for IDEIA and 24.4% (19/78) for Chlamydiazyme. In both specimens, the detection sensitivity was higher for IDEIA. 3. C. trachomatis antigen detection in chlamydial cervicitis (28 cases) by the IDEIA test: The antigen detection rate was 46.4% (13/28) in urethral smears and 60.7% (17/28) in first-voided urine sediments. The detection rate in first voided urine sediments was higher. Thus, in patients suspected of having chlamydial cervicitis, it seems necessary not only to search the antigen in cervical smears but also to study the first-voided urine sediments.(ABSTRACT TRUNCATED AT 250 WORDS)
A diagnosis of nonsecretory myeloma was established in two patients with anemia and proteinuria on the basis of the suppression of polyclonal immunoglobulins and the increase of plasma cells in the bone marrow. No paraprotein was detected in the serum or concentrated urine of these patients. However, a plaque-forming assay of bone marrow cells showed the secretion of monoclonal immunoglobulin by the myeloma cells. Moreover, renal biopsies from both patients indicated the deposition of monoclonal light chains in the glomerular mesangium and basement membrane, as well as in the tubular basement membrane, a pattern consistent with light-chain deposition disease. These observations suggested that the secreted paraprotein disappeared rapidly as a result of enhanced catabolism or deposition in organs such as the kidney, producing severe proteinuria and chronic renal failure. The plaque-forming assay is a useful technique for the demonstration of this type of nonsecretory myeloma, pseudo-nonsecretory myeloma.
To evaluate the operative risk of coronary diseased patients who had severe left ventricular dysfunction, we retrospectively reviewed the cases of 798 patients who had received A-C bypass surgery at Juntendo University between Jan. 1984 and Dec. 1989. The patients with severe left ventricular dysfunction (Ejection Fraction less than 30%) (Group-A, n = 9) were compared with the patients with moderately impaired left ventricular function (E.F. 30%-40%) (Group-B, n = 28) and normal left ventricular function (E.F. greater than or equal to 50%) (Group C, n = 34). The mean E.F. were 21.56 +/- 3.72% in Group-A, 34.28 +/- 3.17% in Group-B, 64.19 +/- 12.02% in Group-C. There were no differences between the 3 groups with regard to Cardiac Index, LVEDP, number of diseased vessels, number of grafts, aortic cross clamp time and cardio-pulmonary bypass time. The percentages of patient who needed catecholamines support in postoperatively were 77.8% in Group-A, 46.4% in Group-B and 61.8% in Group-C. There were no operative and hospital deaths in each of the 3 Groups, whereas 2 patients of Group-A died later of noncardiac disease. We propose that patients with severe left ventricular dysfunction (15 less than or equal to EF, less than 30%) benefit from CABG surgery with low risk, and that each left ventricular E.F., Cardiac Index or LVEDP alone were less significant predictors of operative results as measured by preoperative left ventricular function.
Serum levels of soluble IL-2 receptors (sIL-2R) by an ELISA method in 28 patients with sarcoidosis and 16 healthy controls were studied, and the source of sIL-2R was further examined. sIL-2R in serum was significantly higher in sarcoidosis than in controls. In sarcoidosis sIL-2R in serum significantly correlated with serum ACE level, and was significantly higher in stage II or III patients than in stage O patients. sIL-2R in supernatants of cultured monocytes (Mo) and alveolar macrophages (AM) was significantly higher in sarcoidosis than in controls. sIL-2R in supernatants of cultured T lymphocytes obtained from peripheral blood or BALF was barely detectable in sarcoidosis, while it was undetectable in controls. Furthermore, sIL-2R in serum was significantly correlated with sIL-2R in supernatants of cultured Mo and AM. These results indicate that sIL-2R in serum is an useful index of the disease activity of sarcoidosis, and may be mainly derived from IL-2R on Mo and AM.
Surgical correction of a case of double outlet right ventricle accompanied with complete endocardial cushion defect was completed successfully. No other complicated anomaly existed in this case. Correction was done by using two patch method. The patch for VSD was designed to be comma-like shape. For ensuring the left ventricular out tract, the patch was sutured with bulging at the circumference of the aortic orifice and the suture line of the patch with atrio-ventricular valve was deviated to the right. There was no stenosis in the left ventricular out tract and tricuspid valve.
A female patient with systemic lupus erythematosus (SLE) developed pulmonary aspergillosis with staphylococcal pneumonia and hepatic candidiasis. Aspergillus terreus, which is a rare causative organism of pulmonary aspergillosis, was identified from a pulmonary lesion by culture. The aleurioconidium production, a characteristic of the genus Aspergillus sect. terrei, was demonstrated on short and irregular hyphal features in tissue sections. This report is the first of a combined case of pulmonary aspergillosis due to A. terreus with infections caused by other microorganisms.
Chlamydia trachomatis infection in the general population has recently been attracting attention. In this regard, we examined the incidence of positive antigen in the genital organs in pregnant female women in order to investigate the prevalence of this infection. EIA (Chlamydiazyme) was performed in 5,000 married pregnant women, and in 317 unmarried women who underwent artificial termination of pregnancy. The study was carried out between June 1986 and September 1989 in Sapporo City (3,932 subjects), Kushiro City (328 subjects), Muroran City (280 subjects), Kitami City (357 subjects), Kucchan Town (220 subjects) and Urakawa Town (200 subjects). 1. Among married pregnant women, the detection rate of C. trachomatis was 6.1% (222/3,666) in Sapporo City, 7.3% (24/328) in Kushiro City, 6.1% (17/280) in Muroran City, 7.8% (24/306) in Kitami City, 6.8% (15/220) in Kucchan Town and 7.5% (15/200) in Urakawa Town, showing no particular difference according to the area. The overall detection rate was 6.3% (317/5,000). 2. The rates of detection of C. trachomatis antigen by EIA were 22.9% (61/266) and 15.7% (8/15) for the unmarried women who underwent artificial termination of pregnancy in Sapporo and Kitami, respectively. Both rates were higher than those in the married pregnant women. This result suggests the prevalence of C. trachomatis among young women showing a high level of sexual activity. 3. Among married subjects, the detection rate was 21.3% for those in their late teens, 8.9% for those in their early 20s, 6.0% for those in their late 20s, 3.7% for those in their early 30s, and 2.9% for those 35 years or older; thus, the younger they were, the detection rate became elevated. The above findings show that latent epidemics of C. trachomatis infection are present to a considerable extent among young women.