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Biomedical subjects

F Tanaka

Publications and source records attributed to F Tanaka.

At least 181 records · Page 10Linked to original sources

Fluorometric analysis of native, urea-denatured and refolded human prostatic acid phosphatase.

Human prostatic acid phosphatase (EC 3.1.3.2) was denatured in 6 M urea at pH 2.5, but was refolded by dilution at pH 7.0, as demonstrated by the recovery of nearly complete enzyme activity and dimeric structure. The conformational changes among the native, denatured and refolded states were monitored by means of steady-state and nanosecond pulse fluorometry of tryptophan residues of the enzyme. The relative quantum yield of the fluorescence was highest in the native enzyme and lowest in the denatured one, and was intermediate in the refolded enzyme, although the emission peak was reproducible after refolding. The observed decay curves of tryptophan fluorescence of the native, denatured and refolded states were analyzed by decay functions of three lifetimes. The fluorescence lifetimes of the refolded enzyme were shorter than those of the native one. The fluorescence of the denatured enzyme decayed much faster than that of the other forms. The fluorescence excitation spectra revealed that the excitation energy of phenylalanine was transferred to tryptophan(s) in the native and refolded forms, but not in the denatured form. The efficiency of the energy transfer was higher in the native enzyme than in the refolded one. It was found by excitation polarization spectra that the freedom of internal motion of tryptophans was greater in the refolded enzyme than in the native enzyme. In the denatured enzyme the polarization anisotropies were very low. These results indicate that the higher structure with respect to tryptophans of the refolded enzyme is delicately but definitely different from that of the native enzyme and that local conformation of the active center is recovered upon refolding.

Acid Phosphatase↗

Secondary spontaneous pneumothorax.

To assess the clinical manifestations and therapy of secondary spontaneous pneumothorax (SSP), 123 episodes of SSP in 67 patients were retrospectively reviewed and were compared with 254 episodes of primary spontaneous pneumothorax in 130 patients. The major underlying lung diseases associated with SSP were emphysema (22 patients) and tuberculosis (21 patients). The average age of patients with SSP was 66.8 years, and the most common symptom was dyspnea. The average arterial oxygen tension at onset of SSP was 61.1 +/- 12.1 mm Hg (mean +/- standard deviation), which was lower than that of patients with primary spontaneous pneumothorax (p < 0.01). The recurrence rate of open thoracotomy with pleural abrasion was 12.5% (3 of 24 episodes), which was not lower than that of thoracostomy tube drainage with chemical pleurodesis using tetracycline (recurrence rate, 18.8%) (p > 0.5). We concluded that considering the high age of the patients, the presence of underlying lung diseases, and the increased operative risk, thoracostomy tube drainage rather than open thoracotomy was preferred as the first choice of therapy for SSP.

Adolescent↗

Evaluating bronchial drainage pathways in patients with lung disease using digital subtraction angiography.

RATIONALE AND OBJECTIVES: The purpose of the study was to evaluate the venous drainage pathways of the bronchial circulation during bronchial embolotheraphy or infusion therapy. METHODS: The subjects consisted of 21 patients with lung disorders. All of them underwent bronchial arteriography for drug infusion or embolization. Bronchial arteriography was done using both cut-film and digital subtraction methods. RESULTS: The venous drainage pathways of arteriograms could be determined in 15 (71%) patients and classified into the four types: type 1, direct drainage into a pulmonary vein; type 2, drainage into a pulmonary artery with antegrade flow; type 3, drainage into a pulmonary artery with retrograde flow; and type 4, drainage into a bronchial vein. No drainage route could be identified in six (29%) patients. CONCLUSIONS: Digital subtraction angiography can depict the venous drainage pathways in most patients. Drainage occurs into a pulmonary vein in the majority of patients.

Angiography, Digital Subtraction↗

Psychoses in three cases with myasthenia gravis and thymoma--proposal of a paraneoplastic autoimmune neuropsychiatric syndrome.

Three patients with neuropsychiatric symptoms (NPSs) associated with thymoma, high serum titers of antiacetylcholine receptor (AchR) antibody and generalized myasthenia gravis (MG) are reported. The NPSs were homogeneous; (1) Altered consciousness as manifested by dreamy state with paramnesia, (2) psychosensory symptoms (the sudden change of senses of smell and taste with behavior abnormalities, auditory and visual hallucinations, déjà experiences, microteleopsia and derealization), (3) cognitive disturbances (recent memory loss with compulsive behaviors), (4) emotional disturbances (agitation, fear and anger), and (5) psychotic symptoms (secondary delusions and hallucinations) were characteristic. The NPSs preceded by several months to years the onset of MG, and thereafter they were closely related to worsening and relapse of MG. A typical patient showed repeatedly abnormal electroencephalograms (EEG) indicative of cerebral dysfunction. Another showed improvement of the NPSs after thymectomy and immunosuppressive therapy. The organicity of the phenomenology of psychoses with the same NPSs was suggested and it appears to comprise a unique paraneoplastic syndrome by central autoimmune mechanism. We proposed an autoimmune psychiatric syndrome and the genesis of psychosis due to the central cholinergic dysfunction in MG.

Adolescent↗

Progressive external ophthalmoplegia and myositis.

We reported a senile male patient with progressive external ophthalmoplegia (PEO) and myositis. The ophthalmoplegia was severe, but other neuromuscular features were nearly normal. Muscle enzymes in serum were moderately elevated. Autoimmune, endocrinological or malignant diseases were not observed during the previous 4 years. Pathology of non-weak limb muscles biopsied twice was consistent with active inflammatory myopathy. The ragged-red or cytochrome c oxidase-negative fibers, which are a hallmark of mitochondrial myopathy with PEO, were not increased in comparison with age-matched control muscles. Analysis of mitochondrial DNA in muscle by the Southern blot method did not reveal any deletions. It was concluded that the inflammatory myopathy, myositis clinically localized at the ocular muscles, is an important and distinct disorder in PEO.

Aged↗

Clinical studies of oral quinolone once daily in the treatment of lower respiratory tract infections.

The efficacy and safety of oral ofloxacin, 400 mg once daily, for the treatment of patients with lower respiratory tract infections were studied. The most common species recovered from the sputum specimens of these patients were Haemophilus influenzae, followed by Streptococcus pneumoniae (S. pneumoniae), Staphylococcus aureus (S. aureus), Gram positive cocci unidentified, Pseudomonas aeruginosa (P. aeruginosa), Morexella catarrhalis, Streptococcus epidermidis, and another Haemophilus species in this order. All these bacteria were susceptible to ofloxacin except for one strain of methicillin resistant S. aureus. A satisfactory clinical outcome was achieved in 34 of 40 patients (85%). It is concluded that ofloxacin, 400 mg once daily, is useful for patients with respiratory tract infections.

Administration, Oral↗

[A case of intercostal neuropathy (Th 2-9) due to sarcoidosis].

Neurosarcoidosis is a disorder which presents in 5 percent of cases of general sarcoidosis, in only 10% of which the peripheral nerves are involved. A patient who complained of numbness of the abdomen and back associated with paralytic motion of intestines was admitted. The patient was diagnosed as having neurosarcoidosis of the intercostal nerves (Th2-9) on the basis of abnormality of somatosensory evoked potentials (SEP) and reduced conduction velocity, and evident disease of intrathoracic lesions confirmed by biopsy. Corticosteroid was administered, with relief of symptoms and active response on SEP. Somatosensory evoked potentials and VC were of great value in the diagnosis and follow up of peripheral neuropathy due to sarcoidosis.

Evoked Potentials, Somatosensory↗

[Postoperative lung function in patients with funnel chest].

We evaluated the postoperative lung function determined by spirometry in 54 patients with funnel chest (48 males and 6 females: age range, 4-18 years). Thirty-one patients had sternal turnover as corrective surgery, while 23 had sternal elevation with absorbable PLA (polylactic acid) strut. The mean value of vital capacity as a percentage of predicted (%VC) was 97.3% before operation. %VC was decreased at 3 months (80.5%), 6 months (87.4%), 12 months (82.8%), 24 months (85.9%), and 36 months (77.7%) after the operation (p < 0.01). In patients who had sternal elevation, %VC was decreased at 3 months but not at 6 months, 12 months, 24 months, or 36 months after the operation, while %VC was decreased at any point after the operation in patients who had sternal turnover. No significant changes were seen in forced expiratory volume in one second as a percentage of predicted (FEV1.0%), nor in the ratio of residual volume to total lung capacity (RV/TLC). In conclusion, sternal elevation with PLA strut is a better corrective surgery for funnel chest than sternal turnover, because of its less lung function loss after the operation.

Adolescent↗

[A case of acute bilateral interosseous nerve palsy associated with severe hypopotassemia].

A 66-year-old housewife felt mild pains in both her forearms after wringing a floorcloth repeatedly while cleaning. The following day she was unable to extend her fingers, but could dorsiflex both wrists. A diagnosis of bilateral interosseous nerve palsy was made. Laboratory studies revealed severe hypopotassemia due to laxative abuse and mild rhabdomyolysis, but her general condition was almost good except for the nerve palsies. Nerve conduction studies suggested conduction disturbance of the posterior interosseous nerve in both forearms. Needle electromyography showed a myogenic pattern in all limbs and a neurogenic pattern only in the muscles innervated by the posterior interosseous nerve. As the serum potassium was normalized, she recovered rapidly from the palsies after only seven days. Repeated electrophysiological studies showed that the conduction disturbance and myogenic patterns had disappeared, and only the neurogenic pattern remained in the muscles innervated by the posterior interosseous nerve. The damage to the posterior interosseous nerve caused by repeated pronation and supination of the forearms when wringing a floorcloth was probably mild. However, hypokalemic neuromyopathy had probably already decreased the muscle membrane excitability, so severe palsy occurred following mild nerve damage. The correction of hypopotassemia alone achieved a dramatic improvement of the bilateral palsy because muscle excitability was restored. This rare case suggests that aggravation of entrapment neuropathy may occur due to hypokalemic neuromyopathy.

Acute Disease↗

[ADH 2, 3 and ALDH 2 gene frequency in Japanese alcoholics].

To elucidate genetic susceptibility to alcoholic liver injury (ALD), polymerase chain reaction (PCR) method assay was developed to detect point mutations in each gene and gene frequency in various liver diseases was studied. It was shown previously that ALDH2(1) gene was more frequently found in patients with ALD (confirmed in this study), probably because they are able to consume too much alcohol (non-flushing type). This study revealed that, in addition to this ALDH heterogeneity, ADH heterogeneity may correlate with the severity of alcoholic liver injury, especially in those was low ADH activity and tend to have severe damage.

Alcohol Dehydrogenase↗

[Surgical treatment of metastatic lung tumors].

From January 1970 to March 1991, 72 operations in 55 patients (31 males and 24 females) with metastatic lung tumors were performed in our department. Their cumulative survival rates was 25.5% at five years. With analysis of the various prognostic factors, patients both with solitary metastases and without lymph node metastases had a good prognoses. However, even in patients with recurrent lung metastatic tumors, long time survival was achieved with reoperation in two patients. We concluded that reoperation with or without effective chemotherapies was effective in selected patients.

Adolescent↗

Acute electrolyte disturbances in coronary sinus during left coronary arteriography in man.

Electrolyte disturbances, particularly reduction of ionized calcium, induced by iodinated contrast media (CM) are important considerations in coronary arteriography. A study was conducted in 24 patients to evaluate the acute electrolyte alterations in the coronary sinus during left coronary arteriography. During left coronary arteriography, coronary sinus blood was withdrawn for measurement of electrolytes. The CM used were diatrizoate, ioxaglate, iohexol, and iopamidol. The hematocrit was decreased moderately by all 4 CM used at 5 s and returned to the control level at 15 s. The level of ionized calcium was decreased by all CM at 5 s. Prolonged reduction of ionic calcium was observed with diatrizoate and ioxaglate at 15 s. The level of potassium was almost unchanged by diatrizoate and ioxaglate in spite of hemodilution, which may lead us to a hypothesis that potassium can be released from the intracellular spaces such as red blood cells and vascular endothelial cells. Thus the depression of left ventricular function might be caused not only by reduction of ionized calcium, but also by a relative increase in the level of serum potassium.

Adult↗

Determination of nucleotide sequence of active site for catalytic properties of ADH3 genes.

Alcohol dehydrogenase genes show polymorphism. gamma subunits, which are encoded by ADH3 genes, have two subtypes according to the single base substitution of codon 271 and 349. This mutation of codon 271 directly determines subtypes with different catalytic properties. However, there has been no simple technique to detect nucleotide changes at codon 271. Specific amplification of nucleotides around codon 271 was difficult because of homologous nucleotide sequences around the region among 3 ADH genes (ADH1, 2 and 3). We have developed a method to amplify the ADH3 gene alone with a modification on 3'-end of primer by polymerase chain reaction. Approximately 200 nucleotides including codon 271 of ADH3 gene were sequenced, and genotypes of ADH3 gene were determined in 30 Japanese individuals. This method may facilitate the studies on racial differences of genotypes and involvement of ADH genes in patients with alcoholic liver disease.

Alcohol Dehydrogenase↗

Paraganglioma of the posterior mediastinum: value of magnetic resonance imaging.

A case of paraganglioma arising in the posterior mediastinum in a 29-year-old man diagnosed by magnetic resonance imaging is reported. Excision of mediastinal paraganglioma is often hazardous because of its rich vascular supply and tendency to involve surrounding structures. Magnetic resonance imaging is valuable for the preoperative diagnosis of this vascular tumor as well as for determination of its resectability and appropriate surgical procedure.

Adult↗

High-resolution CT of the temporal bone: a modified baseline.

High-resolution computed tomography (CT) of the temporal bone, particularly axial scanning on a baseline parallel to the orbitomeatal line, produces radiation exposure to the patient's lenses. The authors evaluated the radiation dose to the lens and the visualization of temporal bone structures with use of scanning along the orbitomeatal line and on a line parallel to the hard palate. Evaluation of visualization was performed by five radiologists, with high-resolution CT scans of 45 healthy patients, and the chi 2 test was performed for comparison. The change of the baseline from the orbitomeatal line to a line parallel to the hard palate decreased the radiation dose to the lens from 12.7 cGy to 0.274 cGy and improved visualization of the stapes superstructure and the tympanic portion of the facial nerve canal, although visualization of the incus body, incudostapedial joint, lateral semicircular canal, and oval window was of equal quality. Therefore, the authors recommend a new baseline parallel to the hard palate for use at high-resolution CT of the temporal bone.

Health Personnel↗

[Changes of plombage-operations in respiratory surgery].

The first plombage-operation for pulmonary tuberculosis was by Dr. Nagaishi (1947) and Dr. Wilson, who developed the plombage method employing hollow polymethylmethacrylate spheres. Although the method presented a relatively effective option at a time when no effective drugs were available, its use was discontinued because of such complications as lung injury, cavity-perforation, and empyema. Therefore, soft elastic resin materials, such as those used in sponge-plombage and air-plombage, replaced the hard resin materials. Each plombage method is associated with a certain medical historical period, in Japan. Still the "Kinchyu" method was used. However, the complication of chronic empyema with bronchopleural fistula was difficult to treat. A notable recent method is the pedicled omentum plombage method, which is effective in the treatment of patients who have not responded to standard operations. Finally there was surely a clinical significance in each medical historical period.

Adult↗