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Biomedical subjects

H Okamura

Publications and source records attributed to H Okamura.

At least 451 records · Page 25Linked to original sources
PubMed1993

[Anesthetic management of a patient with acute intermittent porphyria].

A 40-y-o female was scheduled for modified radical hysterectomy and pelvic lymphadenotomy for malignant ovarian tumor. Her past history revealed frequent episodes of reddish discoloration of her urine after physical strain. Her blood and urine samples were submitted for chemical analysis of metabolites of hemoglobin and porphyrin on suspicion of acute intermittent porphyria (AIP). Since these examinations took some days, the patient had to undergo the operation before the results arrived. To prevent an acute exacerbation of possible AIP, some anesthetic drugs had to be avoided. After premedication with atropine 0.5 mg IM, the patient had an epidural catheter placed for later use. General anesthesia was induced with intravenous fentanyl 0.3 mg IV, and inhalation of sevoflurane (0.5-4%) in nitrous oxide and oxygen by mask to eliminate psychological stress during the operation. Then, 0.5% bupivacaine was used through the epidural catheter to block the afferent physical stimulation from the lower half the body. Special attention was paid to stabilize the cardiovascular system. Color of the urine was carefully monitored with a densitometer to find out any early sign of a relapse of AIP during the operation. After the operation, reddish urine and rapid respiration suggested a possible exacerbation of AIP. Fluid therapy with glucose, sedation with chlorpromazine IV and an epidural infusion of buprenorphine (0.5 mg) were performed. The urine became clear several days after the operation and the postoperative course was uneventful. Anesthetic management of patients with AIP is discussed along with the introduction of pertinent literatures.

Adult↗
PubMed1993

Graft replacement of pararenal inferior vena cava for leiomyosarcoma with the use of venous bypass.

Total replacement of the inferior vena cava across the renal vein confluence was successfully performed under venovenous bypass in a patient with primary leiomyosarcoma of the inferior vena cava. Concomitant resection of metastases by right nephrectomy, partial hepatectomy, and cholecystectomy allowed recurrence-free survival for the past 20 months. To the best of our knowledge, this is the first report of successful replacement of the inferior vena cava for a primary tumor.

Female↗
PubMed1992

[Prediction of ovulation by urinary LH surge].

To investigate the usefulness of a semi-quantitative assay of urinary luteinizing hormone (LH) for predicting ovulation, the relationship among urinary LH, serum LH, serum estradiol (E2) and ultrasonographic observations of follicles were examined in 32 infertile women (35 cycles) at spontaneous (7), clomiphene (13) or cyclofenil (3) induced or hMG (12) induced cycles. Their urine samples were collected 3 times a day for LH assay, starting from about the 10th cycle day or when follicles having a diameter of 10mm or more were detected to the day of ultrasonographical confirmation of follicle ruptures. In the morning on these days, blood was taken twice daily for LH and E2 determination at intervals of 30 min. In spontaneous cycles, urinary LH was (P < 0.001) correlated to a significant extent with the serum LH and E2 levels, and follicle rupture was observed 1.9 days after the urine LH surge. In contrast, there was no significant correlation between the urine LH and serum LH or E2 levels in the ovulation induced cycles. In addition, the period from urine LH positive to follicle rupture was significantly (P < 0.05) prolonged in those cycles compared with that in spontaneous cycles. These results suggested that the urine LH determination was good for predicting ovulation in spontaneous cycles, but it was also necessary to monitor the follicle sizes by ultrasonography in ovulation induced cycles.

Adult↗
PubMed1992

High serum IL-6 level reflects susceptible status of the host to endotoxin and IL-1/tumor necrosis factor.

Patients with high level of serum endotoxin did not necessarily develop into lethal shock, whereas some patients died of septic shock even when their serum endotoxin levels were low. These results indicate that limiting factor which determines the host to be endotoxin shock principally depends on the host susceptibility to endotoxin instead of serum endotoxin level. To understand this susceptible status of the host to endotoxin, we used Propionibacterium acnes primed mouse endotoxin shock model. We found that P. acnes-primed mice responded to low dose of LPS by enhanced production of IL-1 and TNF. And such mice were highly susceptible to the lethal shock inducing effect of IL-1 and/or TNF, which also induced high level of serum IL-6 in these mice. Therefore, measurement of serum IL-6 level provides us with the information of the preceding exposure of the host to either LPS or IL-1 and/or TNF and the highly susceptible status of the host to these stimuli. Based on these results obtained from animal model, we investigated the relationship between serum IL-6 levels and serum endotoxin levels in the patients with malignant hematologic disorders. We found that these patients fell into two groups; an endotoxin susceptible group, equivalent to P. acnes-primed mice, showing high level of serum IL-6 with low level of serum endotoxin, and a nonendotoxin susceptible group, equivalent to P. acnes-nonprimed mice, showing low or undetectable level of serum IL-6 with high level of serum endotoxin. We propose that the measurement of serum IL-6 level in the patients positive for endotoxin is a useful tool in evaluating diagnosis and prognosis of endotoxin shock.

Adolescent↗
PubMed1992

The influence of labor on thrombotic and fibrinolytic systems.

Plasma fibrinopeptide A, thrombin-antithrombin III complexes, tissue-plasminogen activator and alpha 2-plasmin inhibitor-plasmin complexes were measured early in the first stage of labor, in the second stage of labor and at 15 min after placental separation. Fibrinopeptide A and thrombin-antithrombin III complex levels did not change from the first to the second stage of labor but increased significantly after placental separation. There was a significant increase of the tissue-plasminogen activator level between the early first stage of labor and the second stage of labor, and it remained high after placental separation. A significant increase in the level of plasma alpha 2-plasmin inhibitor-plasmin complexes was observed after placental separation. These findings suggest that activation of the thrombotic system occurs at the time of placental separation and that activation of the fibrinolytic system begins during labor before placental separation to compensate for the hypercoagulable state which develops at the time of delivery.

Adult↗
PubMed1992

c-myc over-expression in human primary ovarian tumours: its relevance to tumour progression.

Expression of the c-myc gene was analyzed in 56 human primary ovarian cancer tissues, including 51 common epithelial and 5 non-epithelial tumours to determine molecular events in the carcinogenic process in ovaries. Over-expression of the c-myc gene was found in 37.3% of all ovarian tumour tissues, and in 63.5% of serous adenocarcinoma tissues. Significant over-expression of the c-myc gene at Stage III compared with other stages, and one remarkable case of over-expression in a serous tumour of low malignant potential suggest that c-myc expression is temporarily activated at some stage(s) during tumorigenesis of ovarian cancer, especially of serous tumours.

Female↗
PubMed1992

Analysis of laryngeal movement by digital subtraction laryngography.

Fine movement of laryngeal components was analyzed by digital subtraction laryngography with the use of a digital fluorography system. Two kinds of image processing modes, the super pulse image subtraction mode and the time interval difference mode, were used for this purpose. By the super pulse image mode, the distance and extent of movement of laryngeal components at vocal initiation and during phonation could be observed. By the time interval difference mode, the amount and direction of motion for a certain interval and fine movement, such as vocal initiation, were determined.

Fluoroscopy↗
PubMed1992

Distribution of tyrosine hydroxylase immunoreactive nerve fibers in the canine larynx.

The sympathetic innervation of the canine larynx was investigated using tyrosine hydroxylase (TH) immunohistochemistry. Many tyrosine hydroxylase immunoreactive (TH-IR) nerve fibers were observed around arteries and arterioles in the laryngeal mucosa and intrinsic laryngeal muscles. In the glandular region, TH-IR fibers were also found, with some of these fibers terminating around the basement membranes of the glandular cells. The quantity of TH-IR fibers in the mucosa differed among regions of the larynx. Many of these fibers could be found in the laryngeal surface of the epiglottis as well as the posterior glottis. These findings suggest that TH-IR fibers may directly innervate muscles in the intrinsic larynx.

Adrenergic Fibers↗
PubMed1992

Distribution of calcitonin gene-related peptide nerve fibers in the canine larynx.

Immunohistochemistry was used to investigate the distribution pattern of calcitonin gene-related peptide (CGRP) nerve fibers in the laryngeal mucosa, glands and intrinsic muscles of the dog. CGRP immunoreactive nerve fibers were found more frequently than substance P immunoreactive nerve fibers in every region of the larynx. In the epithelia, CGRP nerve fibers were mainly found in the epiglottis, arytenoid region and subglottis. Many taste buds were observed in the arytenoid region and were densely innervated by the CGRP nerve fibers. In the lamina propria, the plexus of CGRP nerve fibers was present, with some of these fibers associated with blood vessels. Laryngeal glands were also innervated by a few CGRP nerve fibers. In the intrinsic laryngeal muscles, abundant immunoreactivity was observed and many motor end-plate-like structures were found with CGRP immunoreactivity. These findings strongly suggest that CGRP plays an important role in all of the sensory, motor and autonomic nervous systems of the larynx.

Animals↗
PubMed1992

Detection of tyrosine hydroxylase and phenylethanolamine-N-methyltransferase messenger RNAs in the mouse adrenal gland and the brain by in situ hybridization.

To study the expression of tyrosine hydroxylase (TH) and phenylethanolamine-N-methyltransferase (PNMT) genes in the mouse adrenal gland and the brain, we performed in situ hybridization studies by using several types of complementary DNA probes recognizing coding regions of human TH (THc), the 3'-end of the human region of TH (TH3'), and the coding region of the human PNMT (PNMTc). THc mRNA was detected in the chromaffin cells of the mouse adrenal medulla and brain catecholaminergic neurons including the substantia nigra and ventral tegmental area. TH-immunopositive neurons were located in a similar pattern in adjacent sections. However no positive signals were detected by the TH3' probe. Using the PNMTc probe, the majority of cells in the adrenal medulla demonstrated positive labelling. Although the mouse TH and PNMT genes have not been fully isolated and sequenced, the present study strongly suggests that the sequence of the coding regions of TH and PNMT are similar in human and mouse. The THc and PNMTc probes are particularly useful in investigating the loci of gene transcription in mouse tissues.

Adrenal Glands↗
PubMed1992

Usefulness of the urinary microalbumin/creatinine ratio in predicting pregnancy-induced hypertension.

In 199 normotensive pregnant women at 20 and 30 weeks of gestation, a fasting urinary albumin/creatinine ratio (FU Alb/Cr) was evaluated to predict pregnancy-induced hypertension (PIH). FU Alb/Cr in patients destined to develop PIH was significantly high compared to that in normotensive women. When FU Alb/Cr of more than 16 was considered to represent a positive test result, the negative predictive value was 94% and 96%, respectively. FU Alb/Cr is a useful screening tool for PIH.

Adult↗
PubMed1992

Inhibition of ovulation in the gonadotropin-primed immature rat by exogenous prostaglandin E2.

In the past two decades there have been innumerable reports that prostaglandins (PGs) are essential for mammalian ovulation. However, we have recently found that a relatively low dose of 0.03 mg indomethacin (INDO) sc to PMSG/hCG-primed immature Wistar rats can significantly reduce ovarian PG levels without inhibiting the control ovulation rate of 60+ ova/rat (1-3). In view of this information, the present study was an effort to duplicate the earlier reports that PGs can reverse the "inhibitory" effect of INDO on ovulation. In control animals, which received PMSG and hCG only, the ovulation rate was 63.8 +/- 4.5 ova/rat. This rate was reduced to 4.1 +/- 1.1 ova/rat when the animals were injected with 1.0 mg INDO at 3 h after hCG. In no instance was this inhibition reversed when the animals were treated with 1.0 mg of PGE2 or PGF2 alpha, or a combination of both prostanoids in either a single dose at 3 h after hCG, or in 4x doses at 2-h intervals beginning at 3 h after hCG. Furthermore, in animals that did not receive INDO, the ovulation rate in PGE2-treated animals was reduced to 20.0 +/- 6.7 ova/rat, and in animals treated with PGE2 and PGF2 alpha (combined) it was reduced to 19.4 +/- 6.5 ova/rat. In summary, not only did the PGs fail to reverse the anti-ovulatory effect of INDO, PGE2 actually suppressed the ovulation rate.

Animals↗
PubMed1992

Immunocytochemical survey of haloperidol-induced immunoreactive changes of [Met]enkephalin-Arg6-Gly7-Leu8 in the rat forebrain.

It has already been demonstrated that chronic treatment with the dopamine receptor blocker, haloperidol, results in an increase of proenkephalin-A-derived peptides in the caudate-putamen (CP). To examine this phenomenon at the cellular level, we used immunocytochemistry to investigate the effects of haloperidol on [Met]enkephalin-Arg6-Gly7-Leu8 (MEAGL) immunoreactivity in the rat forebrain. After daily haloperidol (5 mg/kg, IP, for 6 days) or haloperidol decanoate (70 mg/kg, IM, given once or twice) treatment, immunoreactive neurons appeared diffusely in the whole CP and in the core part of the nucleus accumbens (Acb) and less frequently in the outer shell part of the Acb and the cell-dense layer of the tuberculum olfactorium (TuO). Increase of MEAGL-immunoreactive fibers in the CP, Acb, and TuO was also detected after these treatments, a particularly prominent increase being found in the striopallidal terminals in the globus pallidus and ventral pallidum. Haloperidol or haloperidol decanoate had no effect on MEAGL immunoreactivity in the cerebral cortex, amygdala, or hypothalamus. Reserpine treatment (5 mg/kg, IP, for 6 days) caused similar effects on the dorsal and ventral striopallidal system, and the direct injection of 6-hydroxydopamine (10 micrograms/5 microliters) into the CP led to the appearance of MEAGL-immunoreactive neurons in accordance with the depleted dopaminergic terminal area. These findings suggest that haloperidol influences enkephalinergic neurons region specifically and that in the dorsal and ventral striopallidal enkephalinergic system haloperidol increases MEAGL immunoreactivity in cell bodies, fibers, and terminals by blocking intrastriatal dopaminergic neurotransmission.

Animals↗
PubMed1992

The blood pressure response to infusions of angiotensin II during normal pregnancy: relation to plasma angiotensin II concentration, serum progesterone level, and mean platelet volume.

OBJECTIVE: This study is a survey of the determinants of refractoriness to the pressor effects of angiotensin II during normal pregnancy. STUDY DESIGN: In 25 normal pregnant women, the effective angiotensin II pressor dose was determined 88 times from the twenty-fifth to the thirty-second week of gestation. Immediately before the angiotensin II infusion, blood samples were collected and measured for plasma angiotensin II concentration, serum progesterone level, platelet count, and mean platelet volume. RESULTS: The effective pressor dose had a significantly positive correlation with plasma angiotensin II concentration and serum progesterone level and a negative correlation with mean platelet volume. CONCLUSION: The pregnancy-associated refractoriness to angiotensin II is physiologically determined, at least in part, by the elevated circulating levels of endogenously produced angiotensin II and by the progesterone produced by the placenta, whereas platelet activation attenuates the relative refractoriness during normal pregnancy.

Angiotensin II↗
PubMed1992

The hearing loss in Wegener's granulomatosis: relationship between hearing loss and serum ANCA.

We observed the change of hearing for 1 year in a patient with Wegener's granulomatosis. We also studied anti-human neutrophil cytoplasm antibody (ANCA), which is believed to be specific for this disease and to be associated with disease activity. From these progresses, changes in hearing were considered to be generally related with the general condition and with the ANCA titer level. Because hearing loss in our case was improved by steroids and immunosuppressants, and because ANCA is the autoantibody observed in angiitis syndrome, hearing loss in this case of Wegener's granulomatosis was suspected of being caused by angiitis of the middle and inner ear induced by autoimmune reaction.

Adult↗