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Biomedical subjects

A Usui

Publications and source records attributed to A Usui.

At least 73 records · Page 4Linked to original sources
PubMed1995

Pulmonary nodules in patients with a history of radical nephrectomy for renal cell carcinoma.

BACKGROUND: Nine patients with a history of radical nephrectomy for renal cell carcinoma underwent surgical removal of newly detected pulmonary nodules at the Hiroshima University Hospital. Six patients had metastatic lung tumors two patients had bronchogenic primary carcinomas and one had a granulomatous infection. METHODS: To determine if any characteristics can distinguish a new primary carcinoma from metastatic renal cell carcinoma, we reviewed the nine patients described above. The patients with pulmonary metastases and those with new primary lung cancers did not differ in age, sex, history of smoking, clinical stage and pathological findings of the renal primary site, on the location and size of the pulmonary nodules. RESULTS: Only the interval between the nephrectomy and the appearance of the new pulmonary lesion may be a predictive factor. This interval was 48 and 51 months for the patients with new primary lung cancers but varied from 0 to 39 months for the patients with metastatic renal cell carcinoma. A solitary nodule had an equal chance of being metastatic or primary. CONCLUSIONS: These results indicate that a solitary nodule that is detected at a longer interval after radical nephrectomy may be a new primary lung cancer. Once new pulmonary nodules are identified in a patient with a history of radical nephrectomy for renal cell carcinoma, surgical excision is required for a final diagnosis before initiating therapy for metastases.

Adult↗
PubMed1995

[A case of octogenarian left atrial myxoma].

We reported a case of left atrial myxoma in advanced age. The case was eighty years old man. He admitted with congestive heart failure. He was diagnosed as left atrial myxoma by echocardiography. The open heart surgery was done. The myxoma was 79 g in weight and 8.5x5x3 cm in size. Post operative course was uneventful. The echocardiography is useful for diagnosis of the left atrial myxoma. The left atrial myxoma should be operated when it is diagnosed how the patient is advanced age. The septal-superior exposure gives a good operative field.

Age of Onset↗
PubMed1995

Transurethral collagen therapy in women.

PURPOSE: We evaluated our recent experience with transurethral collagen therapy in women. MATERIALS AND METHODS: A series of 44 women with video urodynamic evidence of intrinsic sphincter deficiency were treated with transurethral collagen therapy using local anesthesia. Median patient age was 72 years (range 41 to 94). Mean duration of incontinence was 72 months. Incontinence was grade 3 in 42 patients. Mean abdominal leak point pressure before treatment was 56 cm. water. Patient response to treatment was evaluated by the change in the number of pads required to effect significant improvement. RESULTS: Median number of pads used was 5 pretreatment (range 3 to 12) and 3 posttreatment. A total of 20 patients was cured and 8 others required only 1 pad daily after treatment (63% cured or needing no pads daily). Of the cured patients 4 had used greater than 10 pads daily before collagen injection. One treatment was given to 22 patients and 7 have not improved of whom 2 underwent only 1 treatment. Mean volume of collagen used to effect a cure was 9.1 cc. CONCLUSIONS: Collagen injection is a useful treatment for the severely incontinent female patient with intrinsic sphincter deficiency.

Adult↗
PubMed1995

[Mitral valve replacement with homemade heterologous pericardial roll valve for mitral regurgitation after repair of complete atrioventricular septal defect].

Repair of using the double patch method was performed on a 6-month old child with Down's syndrome. However, at 1 year and 4 months (BW: 3.6 kg), the patient's resulting mitral regurgitation became severe and clinically unmanageable, necessitating further operation. At operation the anterior leaflet of the mitral valve was lifted up at the anterolateral side due to the patch attached to the interventricular septum, which restricted the valve from closing completely. Moreover, secondary severe hardening of the valve tissue made it difficult to reconstruct the valve. Since the diameter of the valve was only 13 mm after resection, making the impossible use of a standard prosthetic valve, we constructed a new roll valve out of a heterologous pericardium. Almost no regurgitation was observed and prognosis was favorable although a pattern of mitral stenosis was observed. The patient died 6 months later due to the worsening of respiratory infection before a reoperation could be performed. Post mortem examination revealed comparatively good valve function except mitral stenosis due to inadequate valve size. This technique has practical application for mitral valve replacement of small valve annuli of infants when other methods are not feasible.

Bioprosthesis↗
PubMed1995

[Cardiac operation of the cases associated with malignant tumor].

Twelve cases of malignant tumor (mean age 64 years) underwent the cardiac operation. The procedure of cardiac operations were 10 coronary artery bypass grafting and 2 mitral valve replacement. The detail of malignant tumors were 4 gastric cancer, 3 colon cancer, 3 lung cancer, 1 esophageal cancer and 1 lip cancer. The cardiac operations followed the operations of malignant tumor in 4 cases and the cardiac operations were followed by the operations of malignant tumor in 7 cases. The former cases did not recur the tumor from 10 to 30 months follow up period. The all latter cases survived except 1 case from 1 month to 21 months. Our management for the cases associated with malignant tumor and cardiac diseases as next. We perform the cardiac operation for the case whose life expectancy is longer than 1 year. We perform the cardiac operation before the operation of malignant tumor. We perform the operation for malignant tumor as soon as the patient had recovered from the cardiac operation. We would not perform any adjuvant therapy before completion of the operation for the heart and tumor.

Aged↗
PubMed1994

Biochemical and genetic heterogeneity of staphylococcal protein A.

We investigated the biochemical and genetic heterogeneity of protein A from Staphylococcus aureus. SpA genes (spas) of various strains were heterogeneous when detected as DraI and EcoRV fragments of chromosomal DNA. Polymerase chain reaction using primers to detect DNA encoding the IgG-binding domains in spa revealed that they numbered between 2 and 5. Protein A from several S. aureus strains showed two types of reactivities to immunoglobulins in normal canine serum according to the number of active domains.

Base Sequence↗
PubMed1994

Halo congenital nevus undergoing spontaneous regression. Involvement of T-cell immunity in involution and presence of circulating anti-nevus cell IgM antibodies.

BACKGROUND: Halo congenital nevus is a condition in which halo formation is associated with congenital nevocellular nevi. Although several theories have been proposed, the immunologic mechanisms of halo formation and concomitant nevus regression still remain unclear. We presented immunologic findings in a case of halo congenital nevus with unique histologic location of inflammatory cells. OBSERVATIONS: Histologically, the present case of halo congenital nevus undergoing spontaneous regression showed a marked inflammatory infiltrate with remnants of original nevus cell nests. In the infiltrating T cells, CD8+ cells outnumbered CD4+ cells and the infiltrate of natural killer cells was not substantial. Direct and indirect immunofluorescence studies demonstrated the presence of IgM antibodies against nevus cells as well as melanoma cells and cultured melanocytes in the patient's serum. CONCLUSIONS: Our findings suggest that both T-cell-mediated immunity and IgM antibodies may be involved in the regression of halo congenital nevus. However, it is important to point out that our results may simply be epiphenomena and not directly responsible for the destruction of nevus cells.

Antibodies, Neoplasm↗
PubMed1994

The effects of calcium antagonists and prostaglandin E1 on isolated canine coronary arterial tension.

The effects of calcium antagonists (nifedipine, nicardipine, diltiazem, and verapamil) and prostaglandin E1 (PGE1) on the tension of isolated canine coronary arterial strips were studied. In a solution containing 20 mEq/L of K+, 127 mEq/L of Na+, the tension was increased by 500-1,000 mg with 4 mEq/L of Ca2+. This increase in tension was suppressed by Ca-antagonists and PGE1 dose-dependently. Nifedipine 10(-5) M, nicardipine 3 x 10(-7) M, diltiazem 3 x 10(-6) M, and verapamil 3 x 10(-6) M completely suppressed the increased tension. The maximal suppression of the tension produced by PGE1 was about 40% at 10(-10) M. In 20 mEq/L K+ solution (0 mEq/L Ca2+, 37 degrees C), the reduction of the Na+ concentrations from 127 mEq/L to 12 mEq/L increased the tension by 50 to 100 mg. This increase in tension was not suppressed by Ca-antagonists or PGE1. In conclusion, this study demonstrated that Ca-antagonists and PGE1 suppressed an increase in the tension caused by Ca2+ but did not suppress an increase in the tension caused by Na+ reduction.

Alprostadil↗
PubMed1994

Determination of organ blood flows during retrograde inferior vena caval perfusion.

Cerebral, renal, and hepatic blood flows and oxygen metabolism were measured in 8 mongrel dogs undergoing hypothermic (20 degrees C) retrograde perfusion via the inferior vena cava (IVC) and compared with cardiopulmonary bypass and retrograde superior vena caval perfusion. Inferior vena caval perfusion was performed with aortic drainage and clamping of the superior vena cava at an IVC pressure of 20 or 30 mm Hg. Cerebral, renal, and hepatic blood flows at 30 mm Hg of IVC pressure were 7.5 +/- 3.8, 8.1 +/- 3.1, and 15.3 +/- 5.5 mL.min-1.100 g-1, respectively, as determined by the hydrogen clearance method. Organ blood flows during retrograde IVC perfusion were 28%, 42%, and 57% of cardiopulmonary bypass values at a flow rate of 1,000 mL/min and 61%, 119%, and 131% of retrograde superior vena caval perfusion values at 30 mm Hg of superior vena caval pressure, respectively. Oxygen consumption was 7.4 +/- 3.7 mL/min. At an IVC pressure of 20 mm Hg, cerebral, renal, and hepatic blood flows and oxygen consumption were 5.1 +/- 2.7, 5.9 +/- 4.1, and 11.6 +/- 4.0 mL.min-1 x 100 g-1 and 3.0 +/- 0.8 mL/min. As IVC pressure increased, cerebral, renal, and hepatic blood flows and oxygen consumption increased. However, high IVC pressure was associated with high portal venous pressure, which may produce ascites. Regional blood flow during retrograde IVC perfusion was measured by the colored microsphere method in another 8 normothermic dogs. Inferior vena caval perfusion at 30 mm Hg supplied adequate blood flow to the liver (15.44 +/- 12.1 mL.min-1 x 100 g-1) and kidneys (6.35 +/- 2.0 mL.min-1 x 100 g-1).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1994

Neural tissue-related proteins (NSE, G0 alpha, 28-kDa calbindin-D, S100b and CK-BB) in serum and cerebrospinal fluid after cardiac arrest.

To estimate brain damage after cardiac arrest, the concentrations of neuron specific enolase (NSE), GTP-binding protein (G0 alpha), 28 kDa calbindin-D, S100b protein, and creatine kinase BB (CK-BB) in serum and cerebrospinal fluid (CSF) were determined by enzyme immunoassays. Ten mongrel dogs were subjected to 30 min of circulatory arrest at normal body temperature and serial CSF and blood samples were taken during the first 18 h after reperfusion. The NSE concentration in CSF increased significantly after reperfusion, reaching a 15-fold increase (243 +/- 107 ng/ml, p < 0.01) 18 h later, however, it did not increased significantly in serum (8.1 +/- 3.3 ng/ml vs. 23.5 +/- 7.0 ng/ml). G0 alpha concentration in CSF increased sharply between the 2nd and 4th h after reperfusion and peaked 18 h after reperfusion (428 +/- 195 pg/ml, p < 0.01), however, it did not increase significantly in serum. Calbindin-D concentration in CSF increased between the 1st and 6th h after reperfusion, and reached a plateau thereafter (621 +/- 235 ng/ml, a 23-fold increase, p < 0.05) and also increased significantly in serum (p < 0.05). The S100b concentration in CSF also increased dramatically after the 4th h of reperfusion and reached a plateau at the 8th h after reperfusion (16.0 +/- 9.3 ng/ml, a 50-fold increase, p < 0.01), however, it in serum was below the detection threshold. The CK-BB concentration in CSF peaked 4 h after reperfusion (113 +/- 69 ng/ml, a 19-fold increase, p < 0.01) and it in serum increased 4-fold (p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1994

The gene poxn controls different steps of the formation of chemosensory organs in Drosophila.

The gene poxn codes for a transcriptional regulator that specifies poly-innervated (chemosensory), as opposed to mono-innervated (mechanosensory), organs in Drosophila. The ectopic expression of poxn during metamorphosis results in a transformation of the morphology and central projection of adult mechanosensory organs toward those of chemosensory organs. Here we show, by electron microscopy analysis of normal and transformed bristles and by Dil labeling of the innervating neurons, that poxn also controls the number of neurons. To determine whether poxn can transform not only the sense organ precursor cells but also their daughter cells, we examine the effects of the ectopic expression of poxn at different stages of the lineage, and we conclude that poxn can act at a late stage to affect the fate of the undifferentiated neuron.

Animals↗
PubMed1994

Metastatic renal cell carcinoma arising in a native kidney of a renal transplant recipient.

We report a case of metastatic renal cell carcinoma arising in the native kidney of a renal transplant recipient. A 39-year-old man, who had undergone living renal transplantation from his mother at age 32, presented with complaints of paraplegia of the leg caused by a pathological fracture of the 3rd lumbar vertebra. The bone tumor was extirpated and pathological examination revealed metastatic adenocarcinoma. Abdominal computerized tomography showed a tumor in the right native kidney. Right nephrectomy and resection of the right 7th rib tumor were performed. Pathological evaluation demonstrated renal cell carcinoma of the right native kidney (pT2bpN0pV0M1, mixed cell type, grade 2). Postoperatively, cyclosporine was discontinued and natural interferon-alpha was given. The remaining bone metastasis had completely resolved with no significant sign of rejection 1 year after surgery.

Adult↗
PubMed1994

Sleep spindle frequency changes during the menstrual cycle.

Five healthy adult women aged 20 to 28 had 12-15 polysomnographic recordings, as well as daily basal body temperature and multiple LH, FSH, estrogen and progesterone measurements taken during a single menstrual cycle. Sleep stages were scored both visually and with a spindle and delta-wave, real-time, automatic analysing system. A cubic growth-curve model showed that the frequency of sleep spindles changed markedly over the menstrual cycle: spindle frequency was lowest about 18 days before onset of menses and highest 3 days before onset of menses. Slow waves did not change. The percentages of Stage 1 and REM sleep showed small changes during the menstrual cycle, and other parameters of visually scored sleep showed no tendency to change. Spindle frequency may reflect the effects of sex hormones on the reticular thalamic nucleus and may be a quantitative marker of premenstrual sleep disturbances.

Journal Article↗
PubMed1994

Crystal structures of synthetic 7 angstrom and 10 angstrom manganates substituted by mono- and divalent cations.

The crystal structures of synthetic 7 angstrom and 10 angstrom manganates, synthetic birnessite and buserite, substituted by mono- and divalent cations were investigated by X-ray and electron diffractions. The monoclinic unit cell parameters of the subcell of lithium 7 angstrom manganate, which is one of the best ordered manganates, were obtained by computing the X-ray powder diffraction data: a = 5.152 angstroms, b = 2.845 angstroms, c = 7.196 angstroms, beta = 103.08 degrees. On the basis of the indices obtained by computing the X-ray diffraction data of Li 7 angstrom manganate, monovalent Na, K and Cs and divalent Be, Sr and Ba 7 angstrom manganates were interpreted as the same monoclinic structure with beta = 100-103 degrees as that of Li 7 angstrom manganate, from their X-ray diffraction data. In addition, divalent Mg, Ca and Ni 10 angstrom manganates were also interpreted as the same monoclinic crystal system with beta=90-94 degrees. The unit cell parameters, especially a, c and beta change possibly with the type of substituent cation probably because of the different ionic radius, hydration energy and molar ratio of substituent cation to manganese. However, these diffraction data, except for those of Sr and Ba 7 angstrom and Ca and Ni 10 angstrom manganates, reveal only some parts of the host manganese structure with the edge-shared [MnO6] octahedral layer. On the other hand, one of the superlattice reflections observed in the electron diffractions was found in the X-ray diffraction lines for heavier divalent cations Sr and Ba 7 angstrom and Ca and Ni 10 angtrom manganates. The reflection presumably results from the substituent cation position in the interlayer which is associated with the vacancies in the edge-shared [MnO6] layer and indicates that the essential vacancies are linearly arranged parallel to the b-axis. Furthermore, the characteristic superlattice reflection patterns for several cations, Li, Mg, Ca, Sr, Ba and Ni, manganates were interpreted that the substituent cations are regularly distributed in the interlayer according to the exchange percentage of substituent cation to Na+. In contrast, the streaking in the a-direction observed strongly in the electron diffractions for heavier monovalent cations, K and Cs, manganates probably results from the disordering of their cations in the a-direction in the interlayer.

Cations↗
PubMed1994

[Surgical treatment of renal cell carcinoma with extension into the vena cava].

Between 1985 and 1992, 9 patients (6 men and 3 women), 50-76 years old (mean age 63.6), underwent radical nephrectomy and removal of the tumor thrombus for the treatment of renal cell carcinoma extending into the vena cava at the Department of Urology, Hiroshima University Hospital. Seven tumors were located in the right kidney and two in the left kidney. Three tumor thrombi extended into the vena cava within 2 cm (level 1 according to the Novick's classification), 2 extended into the infrahepatic vena cava (level 2), 2 extended into the suprahepatic vena cava (level 3), and other 2 extended into the right atrium (level 4). Two patients had distant metastases preoperatively. The tumor thrombi at the level 1 were removed by venacavotomy with a short duration of surgery and a small amount of blood loss, while in those at the level of 2 or 3, both the duration of surgery and the amount of blood loss increased because the mobilization of the liver needed to remove the thrombi. For removing tumor thrombi at the level 4, cardiopulmonary bypass and deep hypothermic circulatory arrest were applied, resulting in longer duration of surgery but less amounts of blood loss than those at the level 2 or 3. Postoperatively, 2 patients had a renal insufficiency and another 2 had a liver dysfunction. One operative death occurred in this series because of pulmonary embolism.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Nafamostat mesilate reduces blood cell adhesion to cardiopulmonary bypass circuits: an in-vitro study.

Nafamostat mesilate (FUT-175) is a protease inhibitor, working as an inactivator of coagulation, fibrinolysis and platelet aggregation. Although FUT-175 directly blocks contact factors in coagulation, it also may decrease activation of humoral cascade systems when used in cardiopulmonary bypass circuits. We performed an in vitro study using fresh human blood in the following cardiopulmonary bypass circuits: standard circuit (C), biosurfaced circuit (B) and standard circuit containing FUT-175 (F). Each circuit was primed with 500 ml of electrolyte solution and 500 ml of fresh blood. Cardiopulmonary bypass was performed using a roller pump for four hours in two sets of each circuit configuration. Platelet factors (platelet count and beta-thromboglobulin), coagulation factors (thrombin-antithrombin III complex and fibrinopeptide A), fibrinolysis factors (alpha 2-plasmin inhibitor complex and alpha 2-plasmin inhibitor), complement factors (C3a, C4a), free hemoglobin, and granulocyte elastase were measured at the beginning and end of the study. Hemocytograms were measured concurrently. The FUT-175 group showed significantly lower levels of the measured indices than the biosurfaced group in thrombin-antithrombin III complex (7.4 +/- 2.1 vs. 54.9 +/- 38.1 ng/ml), fibrinopeptide A (7.2 +/- 2.0 vs. 20.2 +/- 14.6 ng/ml), beta-thromboglobulin (1940 +/- 250 vs. 2438 +/- 314 ng/ml) and free hemoglobin (25.2 +/- 14.3 vs. 73.8 +/- 18.4 mg/dl). There were no significant differences between Group F and Group B in platelet count, C3a, C4a and granulocyte elastase, although these indices were significantly lower in Groups F and B when compared to Group C.(ABSTRACT TRUNCATED AT 250 WORDS)

Benzamidines↗
PubMed1994

Balloon electric shock ablation. A surgical technique for treatment of ventricular tachycardia: influence of endocardial scar on depth of ablation achieved.

Balloon electric shock ablation is a surgical technique that has been used for treatment of ventricular tachycardia. However, little is known about the energy requirements and precise electrode array best suited to achieve effective ablation of the target area while limiting injury to the surrounding myocardium. This study was designed to determine the effects of endocardial scar (often present at the "site of origin" of clinical ventricular tachycardia) on depth of ablation resulting from balloon electric shock ablation. A chronic canine model of endocardial scar (3.9 +/- 0.6 mm thick) was developed with the use of balloon electric shock ablation techniques. We compared depth of ablation achieved with balloon electric shock ablation with low-energy shocks (22 J per bead) in normal dogs versus those with chronic endocardial scar. No difference was found in depth of ablation in normal dogs and in the scar model (7.2 +/- 1.2 mm versus 6.2 +/- 1.0 mm). Depth of injury expressed as a percentage of wall thickness was not different in the two groups (61% +/- 11% versus 57% +/- 3%). We conclude that the presence of endocardial scar does not influence depth of injury resulting from balloon electric shock ablation. This data provides guidance for clinical application of the technique as a "closed heart" surgical approach for control of ventricular tachycardia. The data are also discussed in relation to energy levels currently used for direct current catheter ablation in patients with ventricular tachycardia.

Animals↗