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Biomedical subjects

A Murata

Publications and source records attributed to A Murata.

At least 55 records · Page 3Linked to original sources
PubMed1999

Earlier prediction of anastomotic insufficiency after thoracic esophagectomy by intramucosal pH.

OBJECTIVES: To assess the value of using intramucosal pH (pHi) measurements to evaluate the viability of the gastric tube after thoracic esophagectomy, and to determine whether these measurements may be used for early prediction of anastomotic insufficiency. DESIGN: Prospective, observational study. SETTING: University hospital in Japan. PATIENTS: Thirty-nine patients who had undergone thoracic esophagectomy as a treatment for esophageal cancer. INTERVENTIONS: The blood flow within the gastric tube was measured using a laser Doppler flowmeter during surgery. Periodic measurement of the pHi within the gastric tube (gastric pHi) began during surgery and continued until the second postoperative day. In 30 patients, the pHi within the rectum (rectal pHi) was measured simultaneously with the gastric pHi. The patients were divided into two groups: those patients who experienced anastomotic insufficiency constituted the leakage(+) group (n = 13); those patients who did not experience these complications were designated the leakage(-) group (n = 26). MEASUREMENTS AND MAIN RESULTS: The gastric pHi values correlated significantly with simultaneous measurements of the blood flow at the anastomotic site (p < .01). The postoperative gastric pHi values increased gradually in the leakage(-) group but stopped increasing after surgery in the leakage(+) group. The rectal pHi values increased gradually after surgery in both groups. Furthermore, there was a significant difference between the two groups when their gastric pHi values were subtracted from their rectal pHi values from the morning of the first postoperative day until the morning of the second postoperative day (p < .05). CONCLUSIONS: The gastric pHi values well reflected the viability of the gastric tube, especially when combined with the rectal pHi values. By measuring pHi, we can more accurately predict the risk of anastomotic insufficiency earlier after surgery and therefore give those patients who need it additional care to improve the viability of the gastric tube.

Adult↗
PubMed1999

[Comparison of Tandem-R PSA and Markit-M PA in the diagnosis of prostate cancer].

The Tandem-R PSA (TR) assay was compared with the Markit-M PA (MM) assay in the diagnosis of the prostate cancer. In patients with a serum prostate specific antigen (PSA) level higher than the cut-off values measured by either the TR assay or the MM assay (4.1 ng/ml and 3.7 ng/ml, respectively), or a suspicious digital rectal examination, sextant biopsy of the prostate was performed. Among 227 patients undergoing biopsy, 64 patients were diagnosed as having prostate cancer. There was a significant difference of serum PSA values between patients with and without prostate cancer in either assay. There was no significant difference between the assays with respect to diagnosing according to prostate cancer using receiver operating characteristic analysis. The correlation between TR and MM in 150 men with a serum Tandem-R PSA below 10 ng/ml was Y = 1.12X + 3.745 (R = 0.68, p < 0.001). The correlation coefficient for the relationship between TR and MM was only 0.68, indicating a poor correlation. Four of the 15 patients with MM values below 4.0 ng/ml calculated by transformation from MM to TR values had prostate cancer. This suggested that conversion of MM values to TR values in the low PSA range presents problems.

Aged↗
PubMed1999

[Cytokine imbalance in critically ill patients: SIRS and CARS].

It remains difficult to treat severely ill patients, especially those who have sepsis and subsequent multiple organ dysfunction syndrome. We propose the hypothesis that the pathophysiology in the sequential sepsis and multiple organ dysfunction syndrome may be strongly related to the imbalance between inflammatory cytokines and antiinflammatory cytokines induced for the host defense to active neutrophils and endothelial cells. Thus we attempted to develop cytokine modulation therapy to normalize the cytokine balance in the host defense system. In this review, we elucidate the relationship between cytokine imbalance and SIRS/CARS in patients with severe burn injury. Furthermore, we examine the possible usage of G-CSF to amplify neutrophil function, and clarify the reasons why various innovative therapies against sepsis have failed.

Critical Illness↗
PubMed1999

[Shock and acute organ dysfunction].

Multiple trauma, hemorrhage, and sepsis may produce various kinds of shock, and such a host as shock could not be controlled and may easily fall into multiple organ dysfunction. Although those mechanisms on the pathogenesis of these sequential inflammatory responses have been clarified recently, the clinical outcome of such patients suffering from severe sepsis and multiple organ dysfunction is still very low. This inflammatory response against the insult shows a sequential manner; cardiovascular system failure, renal system failure, respiratory system failure, central nervous system failure, and finally, hepatic failure. However, the host response to the insult is a kind of defense against the invasion, and the clinical goal might be to stabilize hemodynamic system, metabolic system, and immunologic system. To achieve hemodynamic homeostasis, we use catecholamines and blood transfusion to improve the oxygen supply to important organs and enhance tissue repair. For metabolic homeostasis, early administration of hyperalimentation may be needed, either parenterally or enterally. Enteral feeding may also provided a route for bacterial translocation. To achieve immunologic homeostasis, prophylactic antibiotic administration and metabolic support may be required and should also protect against infection as a secondary invasion. This review explains these mechanisms in terms of the relationship between shock and organ dysfunction and the general features of clinical management.

Anti-Bacterial Agents↗
PubMed1999

[Does the present medical care system satisfy patients with home oxygen therapy (HOT) and home therapy with assisted ventilation (HTAV) in Japan?: an answer from a questionnaire analysis].

The aim of this study was to determine whether the present Japanese medical care system for home oxygen therapy (HOT) and home therapy with assisted ventilation (HTAV) satisfies patients (HOT & HTAV Pts) who receive these therapies. To clarify this issue, we sent questionnaires to 807 patients with HOT and HTAV, 816 practitioners (DRs), and 110 nursing stations (NSs) in metropolitan Tokyo. Responses were eventually received from 79.9% of HOT & HTAV Pts, 32.7% of Drs and 60.9% of NSs. As a result, going to hospitals on regular basis itself (1.3 times a month) forces HOT & HTAV Pts to spend a lot of money and time at present (22.4% spent more than 5,000 yen, and 15.5% more than 60 minutes for a consultation). Although a majority of HOT & HTAV Pts now see a respiratory specialist in larger hospitals, HOT & HTAV Pts wish to see DRs, if the DRs have sufficient ability in HOT and HTAV management. On the other hand, both DRs (86.9%) and NSs (90.6%) consider that case conferences and lectures regarding HOT and HTAV on a regular basis are essential. These meetings are attended by respiratory specialists, DRs, NSs, medical equipment dealers, HOT & HTAV Pts's family members and so forth, because both DRs and NSs feel a certain anxiety about seeing HOT & HTAV Pts (68.3% DRs and 7.5% NSs do not want to see HOT & HTAV Pts). In summary, 1) a majority of HOT & HTAV Pts remain unsatisfied with the present medical care system, 2) a vague anxiety about seeing HOT & HTAV Pts makes DRs tend to avoid HOT & HTAV Pts consultations, 3) NSs frequently feel unsure how to recognize and respond properly to problems concerning HOT & HTAV Pts (62.3%). We therefore conclude that if we could succeed in organizing a better medical care system for HOT & HTAV Pts than the present one, we could turn substantially improve the quality of life of HOT & HTAV Pts in Japan.

Home Care Services, Hospital-Based↗
PubMed1999

Detection of single-stranded cohesive ends in the genome of Bacillus thuringiensis temperate phage KK-88.

Cohesive ends (cos sites) were detected in the genome of temperate KK-88 phage in Bacillus thuringiensis after analysis of the phage DNA generated by the 3'-5' exonuclease activity of Klenow fragment of DNA polymerase I. In addition, unlike the 5'-protruding ends of coliphage lambda genome, the ends of KK-88 phage genome were found to be 3'-protruding. The restriction map of the phage genome was also constructed on the basis of position of the cos fragments.

Bacillus thuringiensis↗
PubMed1998

Identification of novel pancreas-specific regulatory sequences in the promoter region of human pancreatic secretory trypsin inhibitor gene.

The human pancreatic secretory trypsin inhibitor (PSTI) genes introduced into mice are specifically expressed in pancreas. The 1.0 kilobase pairs of PSTI 5'-flanking sequence directed preferential expression of a linked reporter chloramphenicol acetyltransferase, which was active in a PSTI-expressing pancreatic cell line (AR42j) but not in a PSTI-nonexpressing fibroblast cell line (XC). Two positively acting elements were found, Region I (-161/-116) and Region II (-103/-74), as defined by transfection and binding assays with AR42j cells. Region II is sufficient for the pancreas-specific expression, but the presence of both Regions I and II is needed for the maximum activity. Sequence studies also revealed that these two elements differ from the previously identified recognition sequence for pancreas transcription factor 1 (PTF1). When the same set of experiments was done with XC cells, one negatively acting element was identified, Region IV (-154/-137). Interestingly, Regions I and IV share a core sequence (-149/-139), CAATCAATAAC. These results suggest that this novel element regulates the human PSTI gene expression positively in pancreatic cells but negatively in nonpancreatic cells.

Animals↗
PubMed1998

Neural coding of 3D features of objects for hand action in the parietal cortex of the monkey.

In our previous studies of hand manipulation task-related neurons, we found many neurons of the parietal association cortex which responded to the sight of three-dimensional (3D) objects. Most of the task-related neurons in the AIP area (the lateral bank of the anterior intraparietal sulcus) were visually responsive and half of them responded to objects for manipulation. Most of these neurons were selective for the 3D features of the objects. More recently, we have found binocular visual neurons in the lateral bank of the caudal intraparietal sulcus (c-IPS area) that preferentially respond to a luminous bar or place at a particular orientation in space. We studied the responses of axis-orientation selective (AOS) neurons and surface-orientation selective (SOS) neurons in this area with stimuli presented on a 3D computer graphics display. The AOS neurons showed a stronger response to elongated stimuli and showed tuning to the orientation of the longitudinal axis. Many of them preferred a tilted stimulus in depth and appeared to be sensitive to orientation disparity and/or width disparity. The SOS neurons showed a stronger response to a flat than to an elongated stimulus and showed tuning to the 3D orientation of the surface. Their responses increased with the width or length of the stimulus. A considerable number of SOS neurons responded to a square in a random dot stereogram and were tuned to orientation in depth, suggesting their sensitivity to the gradient of disparity. We also found several SOS neurons that responded to a square with tilted or slanted contours, suggesting their sensitivity to orientation disparity and/or width disparity. Area c-IPS is likely to send visual signals of the 3D features of an object to area AIP for the visual guidance of hand actions.

Animals↗
PubMed1998

Profiles of circulating inflammatory- and anti-inflammatory cytokines in patients with hemolytic uremic syndrome due to E. coli O157 infection.

The systemic inflammatory response to Escherichia coli O157 infection was studied from the profiles of circulating inflammatory and anti-inflammatory cytokines. Twelve patients transferred sequentially to our hospital for the intensive care with acute illness due to Escherichia coli O157 infection and the possible form of haemolytic uraemic syndrome were included in this study. Increased circulating concentrations of tumour necrosis factor, interleukin 6, interleukin 8, granulocyte colony-stimulating factor, and interleukin 10 were found in patients with various stages of this infection and haemolytic uraemic syndrome. Especially, the degree of the increase of circulating interleukin 10 in those who had a typical signs of haemolytic uraemic syndrome was higher than those of other inflammatory cytokines. Two groups of E. coli infection could be classified into one with a typical haemolytic uraemic syndrome and the other with atypically bacteremic state over haemolytic uraemic syndrome according to these cytokine levels.

Adult↗
PubMed1998

Successful resection of thoracic esophageal cancer associated with the right aortic arch.

A 52-year-old Japanese man with thoracic esophageal cancer associated with the right aortic arch was admitted to our hospital. Preoperative spiral computed tomography and three-dimensional image reconstruction also showed an associated aberrant left subclavian artery. After preoperative concurrent chemoradiation, the patient underwent a subtotal esophagectomy with regional lymphadenectomy via a left thoracotomy.

Aorta, Thoracic↗
PubMed1998

Primary malignant melanoma of the esophagus associated with adenocarcinoma of the lung.

We herein report an extremely rare case of a 55-year-old Japanese woman with a primary malignant melanoma of the esophagus associated with adenocarcinoma of the lung. The patient was admitted to our hospital with a malignant melanoma of the lower esophagus. The chest X-ray and computed tomography (CT) findings revealed an incidental abnormal shadow in the left lung, which was diagnosed to be adenocarcinoma of the lung by means of a CT-guided needle biopsy. After administering systemic chemotherapy with dacarbazine (DTIC), vincristine sulfate (VCR), and nimustine hydrochloride (ACNU) plus interferon-beta, the esophageal tumor markedly decreased in size. Subsequently, the patient underwent a radical resection of both the malignant melanoma of the esophagus and lung cancer via a left thoracotomy and laparotomy.

Adenocarcinoma↗
PubMed1998

Metabolic engineering of rice leading to biosynthesis of glycinebetaine and tolerance to salt and cold.

Genetically engineered rice (Oryza sativa L.) with the ability to synthesize glycinebetaine was established by introducing the codA gene for choline oxidase from the soil bacterium Arthrobacter globiformis. Levels of glycinebetaine were as high as 1 and 5 micromol per gram fresh weight of leaves in two types of transgenic plant in which choline oxidase was targeted to the chloroplasts (ChlCOD plants) and to the cytosol (CytCOD plants), respectively. Although treatment with 0.15 M NaCl [corrected] inhibited the growth of both wild-type and transgenic plants, the transgenic plants began to grow again at the normal rate after a significantly less time than the wild-type plants after elimination of the salt stress. Inactivation of photosynthesis, used as a measure of cellular damage, indicated that ChlCOD plants were more tolerant than CytCOD plants to photoinhibition under salt stress and low-temperature stress. These results indicated that the subcellular compartmentalization of the biosynthesis of glycinebetaine was a critical element in the efficient enhancement of tolerance to stress in the engineered plants.

Acclimatization↗
PubMed1998

Preventive effect of erythromycin on experimental bleomycin-induced acute lung injury in rats.

BACKGROUND: Erythromycin has been reported to have an inhibitory effect on chronic inflammatory airway disease and chronic infiltration of neutrophils into the airway. Bleomycin (BLM) often induces interstitial lung fibrosis following acute lung injury. A study was undertaken to investigate the effects of erythromycin (EM) on experimental bleomycin-induced acute lung injury in rats. METHODS: Bleomycin-induced lung injury was assessed by light microscopic examination, measurement of neutrophil elastase activity and of the interleukin 8 (IL-8) content in bronchoalveolar lavage (BAL) fluid. The potential inhibitory effect of erythromycin was assessed by overall comparison of erythromycin untreated (BLM alone), concurrently treated (BLM + EM), and pretreated (BLM + pre-EM) groups. RESULTS: The neutrophil count and concentration of neutrophil-derived elastase in BAL fluid were significantly different in the three groups. The morphological changes of lung injury were also less extensive in rats pretreated with erythromycin. However, these protective effects were not marked in the group concurrently treated with erythromycin. Moreover, the concentration of IL-8 in the BAL fluid tended to be less in the erythromycin treated groups; however, there were no significant differences between the bleomycin-treated groups. CONCLUSION: Erythromycin exhibits a prophylactic effect on acute lung injury induced by intratracheal administration of bleomycin, which is possibly associated with a downregulation of neutrophil-derived elastase.

Animals↗
PubMed1998

Prevalence and background factors of maternity blues.

To explore factors contributing to maternity blues, a longitudinal study was carried out on a group of 111 women who received obstetric care at Yamagata University Hospital from November 1994 to August 1995. Cases of maternity blues were found using Stein's Self-Rating Maternity Blues Scale. Mother-child relationships in the women's childhood were assessed using the Parental Bonding Instrument (PBI). Of the 111 women, 17 (15.3%) developed maternity blues during the first postpartum month. The PBI revealed that these depressed women appeared to be cared for less sufficiently in their own childhood than the non-depressed women. As revealed in interviews, they also seemed to receive less support from their families during pregnancy. These findings suggest that maternity blues may be related to insufficient maternal care in childhood, as well as to poor family support during pregnancy.

Adult↗
PubMed1998

Effects of levofolinate calcium on subacute intravenous toxicity of 5-fluorouracil in rats.

To clarify whether levofolinate calcium (1-LV) enhances 5-fluorouracil (5-FU) toxicity, a 4-week toxicity study of 5-FU (10 mg/kg/day) in combination with 1-LV (6, 20 or 60 mg/kg/day) was conducted in rats. In the 5-FU alone group, a decrease in body weight gain, food consumption, RBC parameter and WBC counts were detected. Histopathologically, lymphoid depletion of lymphatic organs, hematopoiesis enhancement of the spleen and myelosuppression were observed. In the group for which 5-FU was combined with 1-LV, the RBC counts decreased, extramedullary hematopoiesis increased and the suppression of lymphatic organs was enhanced. Changes in the lymphatic organs were observed at 20 mg/kg/day of 1-LV and above. In monitoring of blood drug concentrations of 1-LV, 5-methyl tetrahydrofolic acid, a metabolite of 1-LV, and 5-FU after the 1st and 14th dosings, there was no apparent difference between 5-FU alone and 5-FU combined with 1-LV in Cmax and AUC0-infinity. The potentiation induced by 1-LV in the toxicity of 5-FU appeared to be mainly immuno-suppression and myelosuppression, which were related to the anti-tumor activity of 5-FU. Plasma concentrations of 5-FU and 1-LV in this study overwhelmed the concentrations that enhancement of thymidylate synthetase (TS) inhibition due to 5-FU was observed by addition of 1-LV in vitro. Therefore toxic potentiation of 5-FU due to simultaneous 1-LV dosing is presumed to be concerned with an increased ternary complex (FdUMP-TS-5,10-methylenetetrahydrofolate) formation and a greater extent of TS inhibition.

Animals↗
PubMed1998

Discrimination of productive and non-productive cough by sound analysis.

There are two types of coughs, productive and non-productive; the former is caused by excess airway secretions. The analysis of cough may provide important clues not only to aid diagnosis, but also for the selection of drugs for treatment. In this study, cough sounds recorded in a free acoustic field from patients with productive cough and non-productive cough due to chronic airway diseases were compared with those of voluntary cough of healthy subjects and were analyzed by sound spectrogram and time-expanded waveform. All cough sounds could be separated into two or three phases. The implementation of the novel technique to record cough sounds in the free acoustic field and to analyze the sounds of the high frequency range enable recognition of the characteristics of the cough sounds in phase 2 of the cough.

Acoustics↗
PubMed1998

Association of plasmid integrative J7W-1 prophage with Bacillus thuringiensis strains.

A region homologous to the genome of plasmid integrative phage J7W-1 was detected in the largest plasmid in 3 out of 22 type strains of Bacillus thuringiensis, dendrolimus (DEN), aizawai (AIZ) and indiana (IND). Phage induction by ethidium bromide observed particularly in the J7W-1 lysogen was identified in DEN and IND but not AIZ strains. The morphology of the phage induced in DEN and IND strains was identical to J7W-1, but the phage production in IND strain was lower as compared to the J7W-1 lysogen. Although the restriction analysis indicated that the prophage in DEN strain possessed a complete J7W-1 genome, modification and/or deletion had presumably occurred in AIZ and IND strains.

Bacillus Phages↗