Search PubMed⌕ Search

Biomedical subjects

J Kobayashi

Publications and source records attributed to J Kobayashi.

At least 361 records · Page 20Linked to original sources
PubMed1992

[Intra-arterial infusion chemotherapy for recurrent cervical lymph nodes after surgery in esophageal cancer].

We attempted intra-arterial infusion chemotherapy using a reservoir system in recurrent cervical lymph nodes after surgery for esophageal cancer, and obtained favorable results. Intra-arterial infusion chemotherapy (75 mg of cisplatin and 5 mg of peplomycin) was performed using a reservoir system connected with a catheter inserted into the left subclavian artery, because recurrent lymph nodes developed in the left supraclavicular fossa. The therapy was effective for 6 months and the quality of life was improved without side effects.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1992

[Evaluation of mediastinal lymph nodes by computed tomography in lung cancer].

It is important to evaluate hilar and mediastinal lymph node metastasis accurately, since the findings are used to determine the indications for therapies and to estimate the patient's prognosis. Computed tomography (CT) is a useful method for this purpose, but it is known that healthy people may also have lymphadenopathy up to 10 to 15 mm, and metastasis is sometimes observed in lymph nodes less than 10 mm in cases of adenocarcinoma. For this reason, it is necessary to establish an optimal criteria for measured values of lymph nodes on CT images. In this study, we compared the size of mediastinal lymph nodes on CT images and histological findings in 425 lymph nodes of 153 primary lung cancer patients resected in our hospital from 1984 to 1991. Criteria were expressed as possible criteria which can be obtained from ROC analysis with compatibility of sensitivity and specificity, and definite criteria which offer highest efficiency. We analyzed these two criteria by minor axis, major axis, their sum, and their product. As a result, minor axis offered the best criteria. The value of possible criteria was 8.7 mm (sensitivity: 73%, specificity: 70%) and definite criteria was 13 mm (efficiency: 88%) in 425 lymph nodes. Analyzed by histological type, the criteria of epidermoid carcinoma (possible criteria: 9.5 mm, definite criteria: 13 mm) were larger than those of adenocarcinoma (possible criteria: 8.3 mm, definite criteria: 11 mm). Analysed by anatomical region and histological type, the criteria of epidermoid carcinoma varied by with the location of lymph nodes, but those of adenocarcinoma were almost constant.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗
PubMed1992

Evaluation of right ventricular function by regional wall motion analysis in patients after correction of tetralogy of Fallot. Comparison of transventricular and nontransventricular repairs.

Right ventricular function was assessed by regional wall motion analysis and by global function in 62 patients after repair for tetralogy of Fallot. Its relation to surgical procedures, with special attention to right ventriculotomy, was investigated. Patients were classified as follows: group Ia (n = 17), transpulmonary-transatrial repair without right ventriculotomy; group Ib (n = 22), transpulmonary-transatrial repair with minimal right ventriculotomy and small transannular patch; and group II (n = 23), transventricular repair with or without transannular patch. For regional wall motion analysis, fractional area change was used for three anterior parts obtained from hemiaxis area analysis of the lateral right ventriculogram. Ejection fractions were used for global right ventricular function. Functional assessment was done both at rest and during isoproterenol infusion, which is a stress test to evaluate cardiac functional reserve. At rest, group Ia showed better right ventricular anterior wall motion as well as global ejection fraction than did group II. Group Ib showed a global ejection fraction comparable to group Ia, with better regional wall motion in the middle anterior part of the right ventricle despite the depressed upper and lower anterior parts of the right ventricle. Group II showed depressed wall motion of the middle anterior part and the resultant impaired global ejection fraction. During isoproterenol infusion, group Ia showed significant increase in fractional area change of all anterior parts and in global ejection fraction. Group Ib showed significant increases in fractional area change at the middle and lower parts and in global ejection fraction comparable with group Ia. Otherwise, group II showed no significant change in fractional area change, or in global ejection fraction, at the upper and middle parts. These results indicated that transpulmonary-transatrial repair for tetralogy of Fallot provided better postoperative global right ventricular function and its reserve, with less impaired regional wall motion, than did the transventricular repair.

Cardiac Catheterization↗
PubMed1992

[Experimental study on the role of prostaglandin D2 in the pathogenesis of bronchial asthma].

Various kinds of chemical mediators have been implicated in the pathogenesis of bronchial asthma. PGD2 is a cyclooxygenase product which has various physiological effects. In this experimental study, we investigated the role of PGD2 in the pathogenesis of bronchial asthma. In a bioassay system, PGD2 caused dose-dependent contractile responses in non-sensitized guinea pig trachea and lung tissue strips. The subthreshold concentration of PGD2 in both strips was 25 ng/ml. Acetylcholine-induced contractile responses in both strips were significantly increased by continuous infusion of PGD2. In the experimental model of bronchial asthma, the levels of PGD2 were significantly increased in serum, bronchoalveolar lavage fluid (BALF) and lung tissue of sensitized guinea pigs after antigen challenge. We have also reported that the levels of PGD2 in BALF were elevated in patients with stable state bronchial asthma. These results suggest that PGD2 may be a key substance that increases airway responsiveness and induces asthmatic attacks.

Animals↗
PubMed1992

Trp64----nonsense mutation in the lipoprotein lipase gene.

A lipoprotein lipase (LpL) gene defect has been identified, a G----A transition at nucleotide position 446 of exon 3, resulting in a premature termination codon (Trp----stop) at amino acid residue 64. This defect was identified in a Type I hyperlipoproteinemic subject with an amino acid residue 194 defect in the other allele. Plasma lipoprotein values as well as LpL mass and activity in postheparin plasma were determined in the subjects with the residue 64 defect and in other LpL-deficient heterozygotes. LpL mass levels in both the Type I and the other subject with a 64 LpL defect were markedly reduced. This may be explained by rapid degradation of LpL protein or decreased secretion from the 64 defective allele. Alternatively, the marked reduction or absence of mass associated with the 64 defect may be due to synthesis of a severely truncated protein which escapes immunologic detection.

Amino Acid Sequence↗
PubMed1992

Clinical significance of benzoate-metabolizing capacity in patients with chronic liver disease: pharmacokinetic analysis.

Benzoate-metabolizing capacity was studied in control subjects and in liver disease patients after intra-venous loading of 15 mg benzoate per kg of body weight. In the 7 control subjects, the mean level (+/- SEM) of Cmax for serum benzoate was 104.1 +/- 6.8 micrograms/ml, AUC was 2.57 +/- 0.32 mg.min/ml, MRT was 21.5 +/- 1.5 min and T1/2 was 15.5 +/- 1.3 min. For serum hippurate, on the other hand, Tmax was 27.9 +/- 6.0 min, Cmax was 33.4 +/- 2.1 micrograms/ml, AUC was 1.96 +/- 0.13 mg.min/ml, MRT was 39.6 +/- 2.9 min and T1/2 was 30.7 +/- 2.4 min. In 12 patients with chronic hepatitis, Cmax, AUC, MRT and T1/2 for benzoate and Tmax, MRT and T1/2 for hippurate remained at control levels, but Cmax and AUC for hippurate were slightly decreased compared to controls. However, in 18 patients with liver cirrhosis, Cmax and AUC for benzoate were in the control range but MRT and T1/2 were significantly delayed (p less than 0.01 for both). Moreover, the MRT value was increased in proportion to the severity of liver disease (p less than 0.01). AUC for hippurate was not changed to any extent, and Tmax, MRT and T1/2 were slightly delayed, while Cmax was significantly reduced. AUC, MRT and T1/2 for benzoate and Tmax, MRT and T1/2 for hippurate showed significant correlation with serum albumin levels, prothrombin time and indocyanine green clearance rate. These results suggest that benzoate-metabolizing capacity, especially as indicated by the MRT value for serum benzoate, appears to be a better index than the indocyanine green clearance rate for determining hepatic functional reserve in chronic liver disease.

Adult↗
PubMed1992

[Aortic dissection associated with Turner's syndrome].

We report two cases of Turner's syndrome who had had coarctation repair and who ultimately died from complications believed to be associated with Turner's stigmata. Case 1. The repair of coarctation of the aorta (Co/Ao) at age 5 was associated with the tear of the aortic wall and an Asc. Ao-Desc. Ao bypass together with the closure of the Ao proximal to the Co/Ao was performed. At age 10, she developed a dissecting aneurysm of the Asc. Ao seemingly unrelated to the previous surgery and the Asc. Ao was replaced by a prosthetic tube graft. Pathological diagnosis was cystic medionecrosis. The aortic valve was bicuspid. Subsequently, the patient showed progressive worsening of the aortic regurgitation. The aortic valve replacement at age 14 was complicated by significant bleeding and the patient died on the fifth postoperative day. Case 2. Co/Ao was repaired at age 8. During the operation, the aortic wall appeared to be thin and friable, and there was some tear of the posterior suture line which necessitated reanastomosis with resultant stenosis. At age 9, stenotic area was enlarged by an onlay-patch of a piece of woven Dacron arterial graft. There was gradual swelling of that area on routine x-ray examinations and an aortography at age 16 showed definite aneurysm formation. At age 18, she suddenly developed hemoptysis. Rupture of the aneurysm into the pleural cavity and the left lung was suspected. An emergency surgery to stop bleeding under hypothermic cardiopulmonary bypass was unsuccessful and the patient died in OR.(ABSTRACT TRUNCATED AT 250 WORDS)

Aortic Dissection↗
PubMed1992

[The pulmonary venous obstruction following repair with absorbable sutures in total anomalous pulmonary venous drainage--a case report].

A 4-month-old boy with infracardiac type of total anomalous pulmonary venous drainage (TAPVD) who underwent anastomosis between left atrium and common pulmonary vein at age of one month with absorbable suture of polydioxanone (PDS), was suffered from pulmonary venous obstruction (PVO). The ostia of pulmonary veins were stenosed severely. The histological findings showed that there were inflammatory changes and fibrosis around PDS suture. These findings suggested that PDS would cause inflammatory change of tissues around, which might be occurred following repair of TAPVD.

Anastomosis, Surgical↗
PubMed1991

Evaluation of a new finger-type intraoperative epicardial echocardiographic probe for infants and small children.

A new finger-type epicardial echocardiographic probe was evaluated in 26 children with complex cardiac anomalies during open heart surgery. The probe is a small 3.75 MHz phased array transducer for 2-dimensional echo and color Doppler imaging. The tip is slightly angled to facilitate the apical approach through a median sternotomy. The patients included 4 neonates and 8 infants, and the major cardiac lesions were complete atrioventricular (AV) canal, transposition of the great arteries, double outlet right ventricle, and others. The intraoperative study was possible in most of the patients facilitating various approaches for the assessment of left-sided AV valve function, left ventricular outflow obstruction, residual shunt and intraatrial anatomy. Four patients received subsequent operative procedures after the assessment. This transducer appears to be useful in the intraoperative study during surgery for complex cardiac anomalies in neonates and small infants.

Child↗
PubMed1991

Familial chylomicronemia (type I hyperlipoproteinemia) due to a single missense mutation in the lipoprotein lipase gene.

Complete deficiency of lipoprotein lipase (LPL) causes the chylomicronemia syndrome. To understand the molecular basis of LPL deficiency, two siblings with drastically reduced postheparin plasma lipolytic activities were selected for analysis of their LPL gene. We used the polymerase chain reaction to examine the nine coding LPL exons in the two affected siblings and three relatives. DNA sequence analysis revealed a single nucleotide change compared with the normal LPL cDNA: a G----A substitution at nucleotide position 680. This transition caused a replacement of glutamic acid for glycine at amino acid residue 142 of the mature LPL protein. Amino acid sequence comparisons of the region surrounding glycine-142 indicated that it is highly conserved among lipases from different species, suggesting a crucial role of this domain for the LPL structure. Expression studies of the mutant LPL cDNA in COS-7 cells produced normal amounts of enzyme mass. However, the mutated LPL was not catalytically active, nor was it efficiently secreted from the cells. This established that the Gly----Glu substitution at amino acid 142 is sufficient to abolish enzymatic activity and to result in the chylomicronemia syndrome observed in these patients.

Amino Acid Sequence↗