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Biomedical subjects

A Kondo

Publications and source records attributed to A Kondo.

At least 217 records · Page 12Linked to original sources
PubMed1995

[The effects of low dose clonidine on perioperative hemodynamics and anesthetic requirements in elderly patients].

The effects of clonidine, alpha 2-adrenergic receptor agonist, on perioperative hemodynamics and anesthetic requirements were studied in randomized 20 elderly patients without hypertension (ASA I-II) scheduled for elective abdominal surgery under general anesthesia. The control group (n = 10) was premedicated with oral diazepam 0.1 mg.kg-1 90 min prior to arrival in the operating room. The clonidine group (n = 10), in addition, received clonidine approximately 2.5 micrograms.kg-1 orally at the same time. Anesthesia was induced with fentanyl 2 micrograms.kg-1 and thiamylal 4 mg.kg-1. Vecuronium 0.15 mg.kg-1 following 0.01 mg.kg-1 priming dose was used to facilitate endotracheal intubation. Anesthesia was maintained with isoflurane in 50% nitrous oxide-oxygen and supplementary fentanyl. Clonidine effectively attenuated the cardiovascular response associated with laryngoscopy and tracheal intubation. Intraoperative variability of heart rate was significantly lower in patients receiving clonidine compared with controls. No significant differences in the requirements of either isoflurane or narcotic supplementation were observed between the two groups. We conclude that a low dose clonidine is a useful adjunct in the management of elderly patients without producing side effects.

Abdomen↗
PubMed1995

[Studies concerning the pathogenesis of trigeminal neuralgia caused by cerebellopontine angle tumors].

It has been well recognized that neurovascular compression can elicit trigeminal neuralgia (TN) and microvascular decompression surgery has become popular as a radical treatment of this clinical symptom. Cerebellopontine (C-P) angle tumors, however, as well known, can also cause TN. Four hundred fifty six patients with TN underwent posterior fossa exploration between 1984 and 1992 in our clinic, and among them, 45 (9.9%) patients harbored C-P angle tumors which were causative of TN. They included 22 epidermoids, 18 meningiomas and 5 neurinomas. The patient population consisted of 35 women and 10 men, ranging in age from 28 to 73 years, with a mean age of 51.7 years. The mean age of the patients of TN with tumors is considerably lower than that of neurovascular compression patients (61.0 years), particularly in cases of neurinomas (44.4 years) and epidermoids (48.0 years) (p < 0.01). Such difference in ages at the onset of symptom may be explained by the fact that the tumor growth in the C-P angle develops earlier than changes of the vasculature of the vertebrobasilar artery system by aging. Anatomical relationships between the 5th cranial nerve and offending arteries or tumors verified at surgery are as follows; Type A: The nerve is totally encased by the tumor. Type B: The axis of the nerve is distorted by the tumor. Type C: The nerve is shifted by the tumor and is compressed by the artery contralaterally. Type D: The nerve is compressed by the artery which was displaced by the tumor.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

[Treatment of intractable postherpetic neuralgia and blepharospasm: intraneural injection of adriamycin].

Adriamycin, an anthracycline antineoplastic agent, can swiftly be transported to the sensory or somatic motor neurons by way of axoplasmic transport when injected into the subepineurium of the trigeminal nerve or sciatic nerve in experimental animals, and is consequently able to induce degeneration of the neurons without any systemic side effects. Intraneural injection of this agent was carried out for the treatment of a total of 22 patients presenting with intractable neural dysfunction (12 with neuralgia, including 7 with post-herpetic neuralgia and 10 with facial dystonia). The nerve which innervated the affected site was exposed under local anesthesia and approximately 10-60 microliters of 1-20% adriamycin was injected into the subepineurium. Results of the treatment after average follow-up periods of 21.5 months were as follows: Out of 12 patients with neuralgia, good results were obtained in 2 cases (16.7%), fair results in 6 cases (50.0%) (overall effective rate 67.7%). There were no changes in symptoms in 4 cases (33.3%). Out of 10 patients with facial dystonia, good results were obtained in 2 cases (20.0%), fair in 2 cases (20.0%) (overall effective rate 40.0%), and no changes in symptoms in 6 cases (60.0%). No major complications were encountered during these procedures and, once symptoms had disappeared after the treatment, no recurrence of symptoms was experienced. This method clearly differs from other various kinds of simple peripheral neurotomy, since transection of the peripheral nerve does not cause any, destructive changes in the sensory ganglion or motor nucleus and, hence, symptoms may recur.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1995

[Incidence of nausea and vomiting after cholecystectomy performed via laparotomy or laparoscopy].

Postoperative nausea and vomiting (PONV) are commonly observed adverse effects of general anesthesia. In a retrospective study of laparoscopy group (101 patient) and laparotomy group (101 patient), we evaluated the incidence of PONV after laparoscopic cholecystectomy. Most factors which could influence the incidence of PONV were not significantly different between the groups. The overall incidence of PONV during the first 17h postoperatively was 25.7% in laparoscopy group and 18.8% for laparotomy group respectively, but the risk was 3.2 times greater in laparoscopy group (15.8%) than in laparotomy group (5.0%) (P < 0.05) during the first postoperative hour. The risk of PONV was greater in laparoscopy group in female patients (23.4% versus 9.3% in laparotomy group, P < 0.05) and in obese patients (25.0% versus 0% in laparotomy group, P < 0.01) during the first postoperative hour. We conclude that laparoscopic cholecystectomy increases the incidence of PONV in early postoperative period probably by the effect of residual stretching and irritation of the peritoneum, and the risk is increased in female and obese patients.

Anesthesia, General↗
PubMed1995

[Clinical significance of levels of lung surfactant protein A in serum, in various lung diseases].

To assess the utility of measuring lung surfactant protein A (SP-A) in serum, a newly developed SP-A kit (Teijin TDR-30) was used at four facilities to measure serum SP-A levels in patients with various lung diseases. Serum SP-A levels in healthy volunteers were 24.6 +/- 9.6 ng/ml (mean +/- SD). serum SP-A levels did not differ significantly between different age groups (thirties through seventies). A cut-off level of 43.8 ng/ml was calculated, based on the values of the healthy volunteers. The serum SP-A levels in patients with idiopathic interstitial pneumonia (IIP: 67.9 +/- 42.5 ng/ml), pulmonary alveolar proteinosis (PAP: 7.0 +/- 45.7 ng/ml), and collagen disease with interstitial pneumonia (CDIP: 55.3 +/- 37.9 ng/ml) were significantly higher than those in healthy volunteers. When calculated with the cut-off value stated above, the positive rate of diagnosis for IIP was 71.4%. SP-A levels correlated closely with the clinical course; SP-A levels rose significantly during exacerbations of IIP. Measurement of SP-A in serum is useful for the diagnosis of IIP, PAP, and CDIP, and for monitoring exacerbations of IIP.

Adult↗
PubMed1995

Trigeminal neuralgia: association with tentorial meningioma and persistent primitive trigeminal artery.

A rare case of trigeminal neuralgia caused by tentorial meningioma associated with a persistent primitive trigeminal artery (PTA) is reported. This case involved a 59-year-old female patient with a more than 6 month history of left trigeminal neuralgia. A left cerebello-pontine angle (CP angle) meningioma was found associated with a right PTA connecting the proximal portion of the cavernous internal carotid artery with the basilar artery, supplying the bilateral superior cerebellar arteries. The tumor was totally removed via the suboccipital approach, which relieved the pain completely. Since the combination of a CP angle meningioma and a PTA is quite rare in patients with trigeminal neuralgia, we have presented this case here.

Basilar Artery↗
PubMed1995

[Factors affecting continuation of home medical care--based on the relationship between patient and caregiver status].

In recent years it has gradually become possible to have some control over the medical condition of the end-stage cancer patient. However, there are various problems involved in the continuation of home care. In order to clarify how the mutual relationship between patient and caregiver effects the continuation of home care, we conducted a study on 28 end-stage cancer patients who made the transition from our hospital to home care by means of our HOme Care Service. Using the Kaneda Assessment Score, we obtained information from patients' charts, added reasons for rehospitalizations and analyzed the data. The results showed that the group of patients who remained on home care, despite the fact that their condition was significantly poorer than that of the group who discontinued home care, showed a significantly higher proportion of "wishing to be cared for at home to the last," in the view of the caregiver, a joint commitment of the caregiver together with the family, and a suitable response to changes in the patient. As a direction for forthcoming support in this area, there is a need for sufficient assessment in order to evaluate the balance between caregiver and family. It was suggested that guidance in each case and the use of community resources will be very important.

Activities of Daily Living↗
PubMed1995

[The effectiveness of discharge planning (DSP) in home care--comparison of conditions of cancer patient shifted to home treatment before and after DSP introduction].

We developed a discharge planning (DSP) procedure as a method to assess the family and cancer patient situation when making the shift to home care, and we herewith report its significance. DSP is intended to sustain the patient's quality of life (QOL) and improve it; for a smooth transition to treatment at home, the family and patient situation must be assessed from various perspectives. The prospective illness conditions, needed medical treatment and care should be appropriately planned, with due recognition of the roles to be played and the requisite pooling of professional information in order to handle emergencies and the like when such arise. In the present study, in order to clarify issues dealing with DSP effectiveness, we compared 34 patients on home care, 17 before DSP and 17 thereafter. The results indicated that following the introduction of DSP, the home care increased for patients with gastroenterological problems such as pain, general debilitation, poor appetite, constipation, diarrhea and the like and those impulsiveness, vomiting and mental symptoms overlapping. With the proper assessment at the time of the transition to home care, this care could be continued. Moreover, with patient satisfaction, there was the need for assessment over the course in order to evaluate treatment and care. In the days to come, there is the need to improve this approach with a scoring system in the evaluation.

Activities of Daily Living↗
PubMed1995

[A study of clinical significance of leukocyte migration inhibition test in drug-induced hypersensitivity pneumonitis].

In 71 patients suspected of drug-induced pneumonitis, the identification of the allergenic drugs were studied by leukocyte migration inhibition test (LMIT). The LMIT was positive in 61 cases (85.9%). Leukocyte migration activating factor (LMAF) was detected in 22 cases (30.9%), and leukocyte migration inhibitory factor (LMIF) in 39 cases (54.9%), which was found significantly higher than LMAF (p < 0.05). There was no considerable difference in the LMIT-positive rate between interstial and eosinophilic pneumonia. The LMIT-positive drugs were detected in 66 of all 180 suspected drugs, in which 33 drugs (50%) were antibacterial agents and 11 were Kampo prescriptions. beta-Lactam antibiotics accounted for about half the number (16 drugs) in antibacterial agents. LMAF was detected more frequently in beta-lactam antibiotics-induced pneumonitis, which LMIF was detected more often in Kampo prescriptions-induced pneumonitis (p < 0.005). Furthermore, the latent period from drug initial to the onset of pneumonitis were about 10 days in beta-lactam antibiotics-induced pneumonitis and a few months in Kampo prescriptions-induced pneumonitis (p < 0.001). Our findings indicate that LMIT is valuable to identify the allergenic drugs in drug-induced hypersensitivity pneumonitis and that delayed-type hypersensitivity (DTH), with which LMIF is related closely, plays a major role in the pathogenesis of this lung lesion. Furthermore, the pathogenic mechanism of beta-lactam antibiotics-induced pneumonitis may be different from that of Kampo prescriptions-induced pneumonitis.

Adolescent↗
PubMed1994

Distribution of immunoreactive malondialdehyde-modified low-density lipoprotein in human serum.

We developed a sensitive enzyme-linked immunosorbent assay (ELISA) for detection of malondialdehyde-modified low-density lipoprotein (MDA-LDL) in human serum. A monoclonal antibody against MDA-LDL (ML25) used in our method recognized not only MDA-LDL but also other MDA-modified proteins. However, MDA-LDL was able to be detected specifically by using a combination of ML25 and an antibody specific for apolipoprotein B (apo B) (AB16), which was conjugated with beta-galactosidase. Using this method, measurable amounts of MDA-LDL were detected in the sera of 40 healthy individuals. MDA-LDL was observed to be mainly distributed in the human LDL fraction separated by density gradient ultracentrifugation, while in each lipoprotein subfraction the largest amount of MDA-LDL per protein was found at a subfraction between LDL and HDL. The particle size of LDL in this fraction was smaller than that of LDL in the main LDL fraction, as assessed by electrophoresis. In addition, LDL oxidized by Cu2+ was also detectable with this method. We conclude that our method is sensitive and specific for MDA-LDL and might be useful for investigating MDA-LDL in the human circulation.

Antibodies, Monoclonal↗
PubMed1994

Separation of pyridylamino oligosaccharides by high-performance liquid chromatography on an amine-bearing silica column.

Several neutral and sialylated pyridylamino (PA) oligosaccharides were separated on an amine-bearing silica column, PALPAK Type N. Neutral PA-oligosaccharides were fractionated according to the number of sugar residues by amine adsorption. Sialylated PA-oligosaccharides were separated by ion-exchange chromatography. An amine-bearing column was eluted with a mobile phase consisting of acetonitrile and water containing acetic acid titrated to pH 7.3 with triethylamine (TEAA buffer). A mixture of neutral and sialylated PA-oligosaccharides was separated by double-mode HPLC with a solvent program of decreasing acetonitrile concentration (70 to 51%) with a constant TEAA buffer concentration (0.03 M), and then an increasing TEAA buffer concentration (0.03 to 0.49 M) with a constant acetonitrile concentration (51%). This HPLC technique was applied to the comparative oligosaccharide pattern analysis of human Asn-linked oligosaccharides of normal and pathological IgG by hydrazinolysis. The result indicated clearly that oligosaccharides of IgG myeloma proteins have different core structures and ratios of sialic acid than those of IgG normal proteins.

Amines↗
PubMed1994

C-CAM expression in the developing rat central nervous system.

C-CAM, a transmembrane glycoprotein belonging to the immunoglobulin superfamily, can mediate intercellular adhesion by homophilic, Ca(2+)-independent binding. Immunohistochemical analysis of adult rat tissues has demonstrated that C-CAM is expressed in various epithelia, vessel endothelia, and hematopoietic cells. By molecular cloning and sequence analysis several isoforms differing both in the extracellular and the cytoplasmic domains have been found. Here we have analyzed the expression of C-CAM in the developing rat central nervous system. No neuronal expression was observed, but biochemical and immunohistochemical analyses demonstrated that C-CAM becomes expressed in the microvessels from embryonic day E-13; the intensity of the staining increased through day E-15 and then gradually decreased during the perinatal and early postnatal period. The expression of C-CAM in the walls of the microvessels was confirmed by in situ hybridization. Immunoelectron microscopy showed that C-CAM was localized both to the abluminal surface of the endothelial cells and to cellular processes of primordial pericytes where these two cell types are in contact with each other. No staining was found on the luminal endothelial cell surfaces or inter-endothelial cell contact areas. During the perinatal period C-CAM also became expressed on the opposite side of the pericytes and on other cells, possibly astrocytes, in contact with these areas of the pericytes. These observations suggest that C-CAM may be involved in heterotypic, homophilic adhesion between endothelial cells, pericytes and astrocytes, and in maturation of the vessel walls.

Adenosine Triphosphatases↗
PubMed1994

Perioperative allogeneic blood transfusion exacerbates surgical stress-induced postoperative immunosuppression and has a negative effect on prognosis in patients with gastric cancer.

The immunomodulative effect of perioperative allogeneic blood transfusion on host immunocompetence was studied in 109 patients with gastric cancer at various stages. Mitogen-induced lymphocyte blastogenesis, lymphocyte surface markers (specific for T, B, CD4, and CD8 populations), and the activity of natural killer (NK) cells were examined before surgery and then 2 and 4 weeks after surgery. The effects on host immunocompetence of transfusion alone, in the absence of any effect of surgical stress, were studied, preoperatively, in nine patients who received preoperative transfusion. Although a tendency towards a decrease in the posttransfusion activity of NK cells was observed, there were no statistically significant differences between pre- and posttransfusion levels. Mitogen-induced blastogenesis and the activity of NK cells were significantly impaired 2 weeks after surgery in transfused patients as compared to those in nontransfused patients with gastric cancer at stage III and stage IV, and postoperative survival was significantly lower in transfused as compared to nontransfused patients. These results indicate that perioperative allogeneic blood transfusion exacerbates surgical stress-induced postoperative immunosuppression and has a negative effect on prognosis in patients with gastric cancer.

CD4-CD8 Ratio↗
PubMed1994

Pelvic fascia strength in women with stress urinary incontinence in comparison with those who are continent.

Biophysical properties of the anterior vaginal wall as well as the rectus fascia were evaluated in vivo by penetrating the Stamey needle into these tissues of 26 female patients with stress incontinence in comparison with those of 21 continent subjects. The results demonstrated that shear strength of the anterior vaginal wall was lower in incontinent patients than in continent subjects (P < 0.01). Shear strength of the rectus fascia in the patients, which was not supposed to be related to urinary incontinence and should have had the same strength as the control subjects, was also found to be lower than the control (P < 0.01). Shear strength of the vaginal wall was not correlated with age irrespective of their continence status (P > 0.05). Based on our findings it is concluded that some women suffering from stress incontinence may have a hereditary disorder of biophysical properties of the tissues.

Adult↗
PubMed1994

Functional obstruction of the female urethra: relevance to refractory bed wetting and recurrent urinary tract infection.

A 20-year-old woman and 3 girls were referred to our urodynamic unit because of refractory bed wetting, recurrent urinary tract infection, and/or weak stream. All patients required extremely high detrusor pressure to evacuate urine, a mean of 116 cm of water. Urethral configuration was either a ballooning or a spinning-top shape. Organic stenosis of the urethra was not detected by bougie à boule. Urodynamically, functional obstruction at the distal urethra was found to be an etiology of these symptoms. When the urethra was dilated with the Otis urethrotome, all patients were greatly benefitted both symptomatically and urodynamically without an adverse effect of urinary incontinence. We stress clinical importance of pressure flow study and fluoroscopic monitoring of the bladder and urethra when one encounters female patients with long histories of above symptoms.

Adult↗
PubMed1994

High-performance liquid chromatography of glycopeptides and oligosaccharides on graphitized carbon columns.

High-performance liquid chromatography of carbohydrate materials on graphitized carbon columns (GCC) has some advantages over other types of chromatography. Oligosaccharides and glycopeptides with few amino acids are barely retained on reversed-phase columns even under high salt or low pH conditions, but can be retained effectively on a graphitized carbon column. Moreover, elution of GCC requires concentrations of organic solvents lower than that required for normal-phase columns. The usefulness of graphitized carbon columns is exemplified by the following results: (i) Man9GlcNAc2 with only Asn or Asn-Phe (derived from soybean agglutinin) was not retained by a C18 reversed-phase column, but could be separated on a GCC with a gradient of 10-45% CH3CN in 30 min. (ii) Ribonuclease B glycopeptides obtained by Pronase digestion could be separated on GCC with a gradient of 10-30% CH3CN, but they were not retained on a C18 reversed-phase column even with water as eluent. (iii) Oligosaccharides released from ribonuclease B by endo-beta-N-acetylglucosaminidase were separated from each other and peptides on GCC with a linear gradient of 10 mM NH4OH to 10 mM NH4OH-12.5% CH3CN in 50 min at 70 degrees C. Silica-based columns do not allow such an alkaline eluent. (iv) Chito-oligosaccharides (DP 1-9) are well separated within 40 min on GCC with a gradient (10 mM NH4OH-10 mM NH4OH with 25% CH3CN) at 50 degrees C. Chito-oligosaccharides could not be separated by high-performance anion exchange columns such as Carbopac PA-1.

Acetylglucosaminidase↗
PubMed1994

Development and application of thermo-sensitive magnetic immunomicrospheres for antibody purification.

Ultrafine magnetite particles were prepared by a co-precipitation method. The poly-(styrene/N- isopropylacrylamide/methacrylic acid) latex particles containing ultrafine magnetite [magnetic P(St/NIPAM/MAA)] were prepared by two-step emulsifier-free emulsion polymerization. The minimum NaCl concentration for flocculation of these magnetic latex particles (critical flocculation concentration, CFC) decreased with increasing temperature. These temperature dependence of CFC, namely its thermo-sensitivity, originated from NIPAM. At a certain NaCl concentration, some of the magnetic latex particles showed reversible transition between flocculation and dispersion by controlling the temperature, and the thermo-flocculated magnetic latex particles were separated quickly in a magnetic field. Bovine serum albumin (BSA) was covalently immobilized onto the magnetic P(St/NIPAM/MAA) latex particles with high efficiency by the carbodiimide method. These thermo-sensitive magnetic immunomicrospheres were effective for the immunoaffinity purification of anti-BSA antibodies from antiserum.

Antibodies↗