Biomedical subjects

E Okada

Publications and source records attributed to E Okada.

At least 55 records · Page 3Linked to original sources

PubMed1997

Bilobed fasciocutaneous flap for primary repair of a large upper arm defect with secondary closure of the donor site without a skin graft.

Primary repair of 2 patients with large upper arm defects with the bilobed fasciocutaneous flap is reported. In this procedure the repair of a large soft-tissue defect with a flap prepared adjacent to the defect and closure of the flap donor site are performed at the same time without a skin graft. This procedure enabled regional reconstruction and provided excellent aesthetic results. It is simple and reliable. In addition, primary repair of large upper arm defects can be expected.

Aged↗

PubMed1997

The V-Y advancement myotarsocutaneous flap for upper eyelid reconstruction.

The V-Y advancement myotarsocutaneous flap was used to avoid excessive scarring during reconstruction of a full-thickness upper eyelid defect following surgical excision of a malignant tumor. This method has a number of advantages: It has a short operative time, it is a one-stage procedure, it does not require lining by auricular or septal cartilage, the technique is relatively simple, and the scar is inconspicuous, since both flap margins are placed in skin creases. The V-Y myotarsocutaneous flap is best suited for the repair of full-thickness upper eyelid defects ranging from 25 to 50 percent of the lid width when the remaining lateral canthal structures are adequate to support the flap.

Basal Cell Carcinoma↗

PubMed1997

Immunohistochemical studies of proliferating cell nuclear antigen and cathepsin D in transitional cell carcinoma of the urinary bladder.

Immunohistochemical staining for proliferating cell nuclear antigen (PCNA) and cathepsin D was performed on 60 transitional cell carcinoma (TCC) specimens from 60 patients with bladder cancer. The percentage of PCNA-positive cells (PCNA-labelling index) was determined by counting 500 or 1,000 cells, and cathepsin D expression was graded according to the extent of immunoreactivity to anti-cathepsin D antibody. The PCNA-labelling index was significantly higher in high-grade and high-stage tumors compared to that in low-grade and low-stage tumors. Cathepsin D was highly positive in grade-1 tumors. In contrast, 82% of grade-3 tumors and 76% of advanced tumors showed negative or low reactivity to anti-cathepsin D. Groups of high PCNA-labelling index and negative cathepsin D had significantly poorer prognoses compared to those of the low PCNA group and cathepsin D highly positive group, respectively, in univariate analyses. However, neither of these two factors were independent prognostic factors in multivariate analyses. These results suggest that the PCNA-labelling index and cathepsin D expression may indicate the malignant potential of TCC and may be able to provide additional information for predicting survival when stratifying for grade of bladder cancer.

Adult↗

PubMed1997

Drinking habit as a base for blood pressure elevation--difference in epidemiological significance by beverage type.

To investigate whether blood pressure differs by taking preferred alcoholic beverage among habitual drinkers, systolic and diastolic blood pressure (SBP, DBP) were compared among groups with different beverage types in 563 middle-aged Japanese males using data from a cross-sectional health survey conducted from February, 1989 through March, 1991 in five areas of Japan. Mean values of SBP and DBP, adjusted for residence, age and body mass index (BMI), were significantly greater in 'exclusively sake' drinkers (adjusted SBP: 127.2 mmHg, adjusted DBP: 83.0 mmHg) and in 'exclusively shochu' drinkers (adjusted SBP: 127.5 mmHg, adjusted DBP: 84.2 mmHg) than in non-drinkers (adjusted SBP: 120.9 mmHg, adjusted DBP: 77.3 mmHg). Adjusted SBP and DBP of 'exclusively beer' drinkers (adjusted SBP: 121.9 mmHg, adjusted DBP: 79.1 mmHg) were significantly (for SBP: p = 0.016, for DBP: p = 0.008) lower than those of 'exclusively sake' drinkers. Similar patterns of blood pressure differences between five beverage types of habitual drinkers were found especially in the group with less than 150 g of weekly ethyl-alcohol consumption. Even after adding ethyl-alcohol consumption as a covariate among 479 habitual drinkers, the significant differences in adjusted SBP and DBP between 'exclusively beer' drinkers and 'exclusively sake' drinkers (for SBP: p = 0.032, for DBP: p = 0.044) were noted. These results may suggest that the effects of drinking on blood pressure differ by beverage type in middle-aged Japanese males.

Adult↗

PubMed1997

Effect of oxidized low density lipoprotein on thrombomodulin expression by THP-1 cells.

We have investigated the effects of oxidized low density lipoproteins (oxidized LDL) on the expression of TM by THP-1 monocytic cells. TM antigen levels and its cofactor activity for thrombin-dependent protein C activation were increased by oxidized LDL and accompanied by an increase in TM mRNA levels. Incubation of THP-1 cells with 300 microg/ml oxidized LDL for 24 h resulted in an 80% increase of cellular TM antigen levels. Native LDL and acetylated LDL did not affect the TM expression by these cells. The resultant aqueous phase after extraction of oxidized LDL by chloroform/methanol increased the TM antigen levels as well as oxidized LDL. Phorbol 12-myristate 13-acetate (PMA) also increased the TM antigen level 2.1 times the control and was accompanied by the adhesion of cells to plastic dishes and increasing macrophage cell surface antigen CD14 levels. In contrast, oxidized LDL did not induce differentiation to the macrophage. The present results indicate that oxidized LDL increases cellular TM antigen without cellular differentiation and that up-regulation of TM by oxidized LDL in monocytes may have some implication in atherosclerosis.

Arteriosclerosis↗

PubMed1996

Endoscopic extraction of lipomas using an ultrasonic suction scalpel.

Lipomas were extracted with an ultrasonic suction scalpel, assisted by an endoscope, with good results. The combined surgical technique is described in this paper. Preoperative clinical findings and diagnostic imaging of the patients provided a preoperative diagnosis of lipomas. For the procedure, the endoscope was inserted through a small incision immediately above the tumor. The tumor was endoscopically confirmed and then extracted with an ultrasonic scalpel. Complete lipoma extraction was achieved in all patients without recurrence. The patients had good cosmetic results with only minimal postoperative scarring. The endoscopic extraction of lipomas with an ultrasonic scalpel is proven to be highly useful, especially for large tumors, and permits a less invasive and more reliable surgical operation.

Adult↗

PubMed1996

Treatment of vaginal agenesis with an expanded vulval flap.

We propose a vaginal reconstruction method using an expanded vulval flap. This technique avoids long-term dilation and combines the advantages of commonly used methods of treatment for vaginal agenesis, resulting in good functional outcome.

Adolescent↗

PubMed1995

The effect of overlying tissue on the spatial sensitivity profile of near-infrared spectroscopy.

The exact volume of brain tissue interrogated in near-infrared spectroscopy (NIRS) studies of cerebral oxygenation in unknown, the inhomogeneity of the head and resulting variation in optical paths making determination of the interrogated volume difficult. In this study, the spatial sensitivity profiles in simple two-component inhomogeneous cylindrical models are predicted by Monte Carlo simulation in order to reveal the effects of the overlying tissue on the volume of tissue interrogated by NIRS. The predictions are validated by experimental measurements on solid "tissue equivalent' cylindrical phantoms. The phantom diameter is 30 mm and the thickness of the outer layer is 2 mm. The optical properties of the inner cylinder match those of adult brain white matter (mu' s1 = 6.4 mm-1 and mu' a1 = 0.02 mm-1), but those of the outer layer are changed (mu' s0 from 1.7 to 8.3 mm-1 and mu' a0 from 0.002 to 0.1 mm-1). Results show that the spatial sensitivity profile is largely confined to the outer layer at small optode spacing (< 15 degrees) and to the inner layer at large spacing (> 120 degrees). At intermediate angles, the sensitivity profiles are sensitive to the optical properties of the outer layer. A low mu' s0 or mu' a0 moves the profile toward the surface, at high mu' a0 it moves in towards the inner layer and at high mu' a0 it is similar to the homogeneous case.

Biophysical Phenomena↗

PubMed1995

Buttock deformity repair for congenital generalized lipodystrophy.

A 3-year-old girl suffering from congenital generalized lipodystrophy is presented. Almost all features of CGL described by Seip were found in our patient. The deformity of the patient's buttocks was repaired using bilateral gluteus maximus muscle flap advancement, with good result.

Buttocks↗

PubMed1995

A case of right ventricular dilated cardiomyopathy.

This paper presents a sudden death case of 16-year-old girl. She is assumed to have died of ventricular arrhythmia clinically. On autopsy, the right cardiac ventricle was markedly dilated due to extensive infiltration of fibroadipose tissue and resultant depletion of the myocytes, but there was no full thickness disappearance of the contractile element in any part. Considerable parts of remaining myocytes showed degenerative changes similar to those of dilated cardiomyopathy. The left ventricle was moderately dilated. It showed similar significant degenerative changes to the right ventricle, but the degree was less extensive than the right. These findings do not fill the diagnostic requirements of neither Uhl's anomaly nor parchment heart, which reveal almost total depletion of the right ventricular myocytes. However, the findings were consistent with arrhythmogenic right ventricular dysplasia, in case the concept of the entity is extended, we concluded that it would be better to adopt a term--cardiomyopathy--to this case rather than dysplasia. Because, there were considerable histological evidence of myocardial degeneration suggesting primary myocardial disease rather than congenital defect in nature. We diagnosed, therefore, this case as right ventricular dilated cardiomyopathy, comprising a type of dilated cardiomyopathy whose myocardial lesions predominate in the right compared to the left ventricle.

Adipose Tissue↗

PubMed1994

The biphasic changes in splenic natural killer cell activity following ventromedial hypothalamic lesions in rats.

The cytotoxic activity of natural killer (NK) cells in the spleen was measured by a standard 4-h chromium release assay following electrical lesioning of the ventromedial hypothalamic nucleus (VMH) in rats. The splenic NK cell activity of VMH lesioned rats was found to be significantly suppressed at effector:target cell ratios of 100:1 and 50:1 compared with that of sham lesioned rats on day 4 after the lesion. On the other hand, on day 49, the VMH lesioned animals that had become hyperphagic and obese showed an enhancement of splenic NK cell activity compared with sham lesioned animals. The mechanisms of the biphasic change in NK cell activity following the VMH lesions are discussed.

Animals↗

PubMed1994

Selective intrathecal phenol block to improve activities of daily living in patients with spastic quadriplegia. A preliminary report.

To eliminate severe leg spasms of 15 quadriplegics, 0.3 ml 10% phenol-glycerin was injected into the subarachnoid space at the T12/L1 interspace. The effectiveness for leg spasm was evaluated by the Penn spasticity and Ashworth rigidity scales. Three patients remained completely flaccid; however three had slight, six had moderate and three had complete recurrence of spasms in a follow up period of observation for 1 to 22 (average 13) months. The result of selective intrathecal phenol block was significantly valuable, improving the activities of daily living (ADL) of quadriplegic patients. There were no systemic side effects nor disturbance of bladder, bowel or sexual functions.

Activities of Daily Living↗

PubMed1994

[Factors related to postoperative hydronephrosis following ureteroneocystostomy in neurogenic bladders].

A total of 68 ureteroneocystostomies performed between 1980 and 1992 in 63 patients with vesicoureteral reflux (UVR) secondary to neurogenic bladder were reviewed to elucidate factors of postoperative hydronephrosis. Urogram, cystogram, and urodynamics were analyzed, and the cases were classified into two types (areflexia, hyperreflexia) of detrusor muscle response. Occurrence or progression of hydronephrosis was demonstrated in 26 operations (complicated group). Compared with the rest (uncomplicated group), significant difference was not observed concerning proportions of vesical deformity, VUR grades, preoperative hydronephrosis, cystometric types and operative factors. In cases of hyperreflexia maximum vesical volume, maximum vesical pressure or maximum urethral pressure was not different between both groups. However, in those of areflexia maximum vesical volume of the complicated group was significantly smaller than that of the uncomplicated group (290 +/- 35 ml vs. 370 +/- 35 ml, P = 0.03), and the proportion of bladders with compliance less than 10 ml/cmH2O was significantly higher in the complicated group than in the uncomplicated group (P = 0.05) though maximum vesical pressure or maximum urethral pressure was not different. In areflex bladder deformity was observed more in the complicated group than in the uncomplicated group (P = 0.06). Relative inactiveness of detrusor muscle in areflex bladder might render such preoperative findings as vesical deformity, contracted bladder and low compliance more prognosticative of postoperative hydronephrosis than in hyperreflex bladder. During the follow up (6 to 132, mean 42 months) no case showed progression of hydronephrosis or renal deterioration, nor did any case require revisional surgery.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1993

Combination chemotherapy with 254-S, ifosfamide, and peplomycin for advanced or recurrent cervical cancer.

BACKGROUND: Based on the fact that combination chemotherapy with cisplatin, ifosfamide, and bleomycin generated a 69% response rate in patients with recurrent cervical cancer; that 254-S (a cisplatin analogue) monotherapy generated a 46.3% response rate for cervical cancer, which was higher than those generated by cisplatin and carboplatin in historic comparison; and that peplomycin is a bleomycin analogue with improved pulmonary toxic effects, a combination regimen with 254-S, ifosfamide, and peplomycin was evaluated in an animal experiment and a clinical study in patients with advanced or recurrent cervical cancer with an expectation that the regimen might show a higher efficacy than 254-S monotherapy and the combination regimen including cisplatin. METHODS: In the clinical testing, 254-S was administered intravenously (IV) at 80-100 mg/m2, ifosfamide was administered IV at 1500 mg/patient for 5 days, and peplomycin was administered intramuscularly at 5 mg/patient for 6 days. This treatment was repeated every 4 weeks. RESULTS: As a result, this regimen showed additive or synergistic antitumor effects in mice receiving B16 melanoma transplants. In the clinical study, 83.8% and 60.9% response rates were obtained in 37 previously untreated patients with Stage III or IV cervical cancer and 23 with recurrent cervical cancer, respectively. The dose-limiting factor was bone marrow toxic effects, which were tolerable. The other toxic effects were mild, and there were no deaths. CONCLUSIONS: From these results, this combination regimen was thought worthy of evaluation in a Phase III comparative study in patients with advanced or recurrent cervical cancer.

Adult↗

PubMed1993

A pathological study of intracranial posterior circulation dissecting aneurysms with subarachnoid hemorrhage: report of three autopsied cases and review of the literature.

Three autopsied cases of dissecting aneurysms with spontaneous subarachnoid hemorrhage of the intracranial posterior circulation are reported, and the literature is reviewed to investigate the pathological characteristics and pathogenesis of this lesion. The location and pathological features of the aneurysms were different in each of the cases presented. Subadventitial hemorrhage associated with the subarachnoid hemorrhage, multiple noncontiguous intramural hemorrhages, and new vessels in and around the arterial wall were noteworthy findings in our series. All 20 reported autopsied cases of the vertebrobasilar artery have a dissection between the media and adventitia with a rupture site in the thin adventitia. Seventeen of them had disruption of the entire arterial wall, but the remaining three cases had no apparent luminal connection. The clinicopathological features of this disease are various. On the basis of the pathological investigations of these reported cases, the pathogenesis of this lesion is discussed. Intramural hemorrhage associated with dissection without luminal connection should not be disregarded as a causative factor.

Aortic Dissection↗

PubMed1993

Microscopic laser Doppler velocimeter measuring blood velocity in single microvessel.

A microscopic laser Doppler velocimeter to measure blood velocity in single microvessels was developed. In order to measure the blood velocity in microvessels correctly, the influence of stray scattered light from vessel wall should be removed. Because it provokes low-frequency spurious components. The spectra of the spurious components overlap with that of Doppler signal and induces considerable error in the result of the blood velocity when the velocity is reduced. The optical configuration of the velocimeter was optimized to eliminate the influence of the stray scattered light. The blood velocity in microvessels in rat mesentery was measured with the microscopic laser Doppler velocimeter and the periodical fluctuation of the velocity was analyzed. Pulsatile velocity fluctuation could be observed even in capillary.

Animals↗

PubMed1992

Feeding suppression elicited by electrical and chemical stimulations of monkey hypothalamus.

The effects of electrical (ES) and chemical stimulations of the hypothalamus were investigated in monkeys during bar-press feeding. ES elicited both prolonged and nonprolonged types of suppression of bar-press feeding in hungry animals. Prolonged type suppression persisted for greater than 1 min beyond one or more post-ES trials and was found after ES of the dorsomedial hypothalamus (DMH), the ventromedial hypothalamus (VMH), and the ventromedial part of the lateral hypothalamic area (LHA). Non-prolonged type suppression was observed only during ES at some sites of both in hypothalamic and extrahypothalamic areas. A microinjection of glutamate into the VMH and the DMH, but not into the LHA, was able to reproduce the ES-induced prolonged type suppression. In contrast, the ES of the LHA, but not the VMH and DMH, in a satiated state provoked feeding. The results, together with the previous findings, suggest that the neuronal inhibitory mechanism of feeding exists in the VMH and DMH, while both the neuronal facilitatory and axonal inhibitory mechanisms in the LHA are involved in the feeding regulation, and these mechanisms of the LHA are affected by the hunger/satiety state.

Animals↗

PubMed1992

[Combination chemotherapy with 254-S, ifosfamide and peplomycin for advanced or recurrent cervical cancer].

From favorable results with 254-S, a new cisplatin analogue, single administration, we have conducted a clinical study to investigate the efficacy of combination of 254-S, ifosfamide and peplomycin, each of which has a different dose limiting factor. A total of 45 patients, including 22 patients with stage III and IV cervical cancer and 23 cases with recurrent cervical cancer, were treated with at least two courses of 254-S (100mg/m2, iv. Day 1), ifosfamide (1,500mg/body, iv. Day 1-5) and peplomycin (5mg/body, im. Day 1-6), and tumor response was evaluated clinically and by CT scanning. The response rate obtained in patients with advanced disease was 81.8% (PR = 17, CR = 1) and that in cases with recurrence was 60.9% (PR = 12, CR = 2). Myelosuppression was the dose limiting factor. In the 121 courses, grade 3 and 4 of leucopenia and thrombocytopenia were observed with an incidence of 44% and 32%, respectively and DIC occurred in 3 cases with poor PS though they recovered after reducing the 254-S dose to 80 mg/m2. The other toxicities were mild except for alopecia. Anaphylaxia was observed in a case at the second administration though the patient recovered in 15 minutes. There was no death. As to prognosis, a significant prolongation of survival period was observed in recurrent cases and 4 cases are alive (NED) after one and a half year. In the advanced cases, until now 3 cases of stage IV have died from the disease. We have concluded that this regimen is effective as a neoadjuvant chemotherapy for advanced cervical cancer and useful for the treatment of recurrent cervical cancer.

Adenocarcinoma↗