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Biomedical subjects

J Sakata

Publications and source records attributed to J Sakata.

At least 19 recordsLinked to original sources
PubMed2006

Number of positive lymph nodes independently affects long-term survival after resection in patients with ampullary carcinoma.

AIM: The nodal status is an established prognostic factor in ampullary carcinoma. The aim of this study was to compare the prognostic power of the anatomic location of positive nodes with that of the number of positive nodes. METHODS: Of 73 consecutive patients treated for ampullary carcinoma, 62 underwent pancreaticoduodenectomy with regional lymphadenectomy. A survival analysis of these 62 patients by nodal status was conducted retrospectively. A total of 1942 lymph nodes taken from the patients were examined histologically for metastasis. The location of positive regional nodes was classified into 4 categories, according to the Japanese staging system. The number of positive regional nodes was recorded for each patient. The median follow-up period was 124 months. RESULTS: Nodal disease was found in 31 patients, of whom 23 had 1-3 positive regional nodes and 8 had >or=4 positive regional nodes. Univariate analysis revealed that both the location (p<0.0001) and the number (p<0.0001) of positive nodes were significant prognostic factors. Multivariate analysis revealed that the number of positive nodes was an independent prognostic factor (p=0.007), while the location failed to remain as an independent variable. The median survival time was 59 months with a 5-year survival rate of 48% in patients with 1-3 positive nodes, whereas all patients with >or=4 positive nodes died of the disease within 29 months of resection (p=0.0001). CONCLUSION: The number, not the location, of positive regional lymph nodes independently affects long-term survival after resection in patients with ampullary carcinoma.

Adult↗
PubMed2003

[Penetrating cardiac and pulmonary injury by a nail-gun: report of a case].

A 64-year-old man underwent emergency operation for self-inflicted penetrating cardiac and pulmonary injury by a nail-gun. Chest films on admission showed 5 nails penetrating the thorax and one of these nails had reached into pericardium. Emergency surgery was performed by median sternotomy and the 5 nails in the chest wall were totally removed and the wound of right ventricle and lung were closed with direct mattress sutures without cardio-pulmonary bypass. Post operative course was uneventful and he was transferred to the psychiatric ward for the treatment of depression at post operative 7 days.

Cardiac Surgical Procedures↗
PubMed2003

[Utility of the perfusion-assist for beating heart coronary artery bypass surgery].

During off-pump coronary artery bypass surgery, concern remains about the possible myocardial injury associated with the transient occlusion and stabilization of the target vessels. To try to minimize myocardial ischemia and achieve hemodynamic stability, we utilized a coronary perfusion catheter combined with the perfusion-assisted direct coronary artery bypass system that enables active and modified coronary perfusion of the target vessel throughout the duration of multiple grafting (modified PADCAB). In the series of 10 patients, perfusion of the target coronary systems averaged 2,072.8 +/- 649.7 ml over 92.9 +/- 26.1 minutes under a constant infusion pressure of 120 mmHg. Nitroglycerin (100 micrograms/l of flow) was delivered directly into the coronary arteries as an additive in all patients. Hemodynamic instability was notably absent in all cases, even in cases that required difficult anastomosis with a relatively long time for the anastomosis. There were no perioperative complications and no detectable myocardial damage (i.e., impairment of myocardial wall motion indicated by echocardiography findings or by > 0.25 ng/ml of troponin-T release compared to the preoperative level) in this series of patients.

Aged↗
PubMed2000

Primary pericardial mesothelioma presenting as constrictive pericarditis: a case report.

Primary malignant pericardial mesothelioma is a rare tumor and the case reported here presented as constrictive pericarditis. The patient's symptoms progressed day by day despite treatment with digitalis, diuretics and catecholamines. Although a computed tomographic scan of the chest, echocardiography and pericardiocentesis were performed, a preoperative definitive diagnosis could not be obtained. Emergency pericardiectomy and partial resection of the tumor were carried out with the aid of a percutaneous cardiopulmonary supporting system, but the patient died of cardiac failure on postoperative day 3. The tumor appeared to be the biphasic type of diffuse malignant mesothelioma. The prognosis for pericardial mesothelioma is extremely poor due to its late presentation and difficulty in completely removing it surgically and, unfortunately, there still is not a radical therapy for this tumor.

Diagnosis, Differential↗
PubMed2000

[One advice to the decision of graft size for ascending and total arch graft replacement (in a case of differential diameters in ascending aorta and descending aorta)].

We carried out the surgery of thoracic aortic aneurysm in fifty-eight patients from June 1994 to February 1999 (including aortic dissection in twenty-six patients). The mean size of grafts were 28.1 mm in ascending graft replacement, 25.8 mm in both ascending and arch graft replacement and 23.8 mm in descending graft replacement. The grafts for ascending aortic aneurysm were significantly larger than those for descending aortic aneurysm. In two of twenty-six patients undergoing both ascending and arch graft replacement, different size of grafts were used for ascending replacement and for arch replacement with satisfactory results in terms of bleeding from the anastomotic sites. Case 1; A 45-year-female with aortitis syndrome and aortic regurgitation due to annuloaorticectasia and thoracic aortic aneurysm underwent simultaneous aortic root replacement with composite graft (25 mm St. Jude Medical valve and 28 mm Hemashield graft) and total arch replacement (30 mm Hemashield graft with two side branches). Case 2; A 64-year-female was diagnosed as chronic type II dissecting aneurysm combined with acute type I aortic dissection. Ascending aorta was replaced with a 26 mm Hemashield graft, and the aortic arch was replaced with a 24 mm Hemashield graft with three side branches.

Anastomosis, Surgical↗
PubMed2000

[A successful repair of intraoperative retrograde type A aortic dissection in a patient with aortic regurgitation and ascending aortic aneurysm].

The patient was a 67-year-old male with aortic regurgitation and ascending aortic aneurysm. We noticed the type A retrograde aortic dissection occurring from the cannulation site through the right femoral artery. We discontinued cardio-pulmonary bypass immediately, and established selective cerebral perfusion (SCP) eleven minutes after retrograde cerebral perfusion (RCP). We underwent simultaneous aortic valve replacement and ascending and arch graft replacement with an aid of SCP combined with RCP and systemic low flow perfusion. Postoperative course was satisfactory, although patient had a transient neurologic deficit. Intraoperative aortic dissection is a rare but potentially fatal complication. RCP may be a simple and useful method in emergency operation for intraoperative retrograde type A aortic dissection to avoid serious cerebral damage.

Aged↗
PubMed1999

Novel distribution of adrenomedullin-immunoreactive cells in human tissues.

Adrenomedullin (AM) is a novel hypotensive and vasodilator peptide. We previously examined the localization of AM in human, rat, and porcine tissues using a polyclonal antibody against synthetic human AM[40-52]. We demonstrated that AM is widely distributed in the endocrine and neuroendocrine systems, but not in the heart, kidney, or blood vessels, although high levels of AM mRNA were detected in the latter tissues. In this study, we further investigated the distribution of AM by using two newly developed monoclonal antibodies against synthetic human AM peptides, [12-25] and [46-52]. AM immunoreactivity was observed in cardiac myocytes, vascular smooth muscle cells, endothelial cells, and renal distal and collecting tubules. In addition, AM-immunoreactive (IR) cells were found in mucosal and glandular epithelia of the digestive, respiratory, and reproductive systems, as well as the endocrine and neuroendocrine systems. These findings indicate that AM-IR cells are more widely distributed in human tissues and suggest that AM might play multiple biological roles in humans.

Adrenomedullin↗
PubMed1999

Cell density of adrenomedullin-immunoreactive cells in the gastric endocrine cells decreases in antral atrophic gastritis.

AIMS: Adrenomedullin (AM) is a novel hypotensive and vasorelaxing peptide recently isolated from human phaeochromocytoma tissue, and is widely distributed in various organs. In this study we examined the localization of AM-immunoreactive (IR) cells in the gastric mucosa and AM-IR cell density in antral atrophic gastritis. METHODS AND RESULTS: Gastric mucosal tissues were taken from the gastric body and antral mucosa of 52 patients (27 men, 25 women; mean age 56.0 (range 20-86) years). Immunohistochemical analysis revealed that AM-IR cells were present in the pyloric glands, but not in the fundic glands, and that AM-IR cells were stained positively for chromogranin A and gastrin. The percentage of AM-IR cells vs chromogranin A- and gastrin-IR cells was 42 and 56%, respectively. The number of AM-IR cells decreased with the progression of severity of atrophic changes in the pyloric gland, and also of mononuclear cell infiltration. There was no correlation between the number of AM-IR cells and the degree of neutrophilic infiltration. Similar findings were also obtained for gastrin-IR cells. CONCLUSION: AM-IR cells are present in the endocrine cells including gastrin-IR cells in the pyloric glands. These results suggest that AM may contribute to gastrin secretion in the pyloric glands.

Adrenomedullin↗
PubMed1999

Marked increase of guanylin secretion in response to salt loading in the rat small intestine.

Guanylin and uroguanylin are intestinal peptides that stimulate guanylate cyclase C and cause chloride secretion. These peptides show topological instability due to two disulfide bonds. The disulfide bonds were reduced and S-carboxymethylated to cleave the bonds and obtain stable and sole derivatives. We established a new and reliable RIA system for the stable derivatives from both peptides. With the use of this system, the response of the peptides to salt loading of the rat small intestine was evaluated. The lumen of the small intestines of Sprague-Dawley rats was perfused in vivo with Krebs-Ringer solution containing different concentrations of salt or mannitol. Mature guanylin, proguanylin, and mature uroguanylin were found in the perfusate in the basal state. The highest salt loading (200 mM NaCl for 20 min) increased the guanylin secretion about threefold (1.9 +/- 0.2 vs. 5.4 +/- 0.5 pmol/min), with the effect lasting for 60 min. The uroguanylin secretion was less affected. Hyperosmolar mannitol also caused a significant but smaller increase of guanylin secretion. Increased guanylin could lead to increased salt and water secretion of the intestine; thus members of the guanylin family have potential roles in the regulation of water and salt metabolism in the small intestine.

Amino Acid Sequence↗
PubMed1999

Effect of septal lesions on male song and aggression in the colonial zebra finch (Taeniopygia guttata) and the territorial field sparrow (Spizella pusilla)

The present investigation assessed the effect of lesions of the septum on male courtship and aggression in the territorial field sparrow (Spizella pusilla) and the colonial zebra finch (Taeniopygia guttata). In addition, pair-bonding and a variety of other social behaviors were examined in the zebra finch and dawn song (both the strictly agonistic song type and the multipurpose song type) was examined in the field sparrow. Zebra finches were tested in three phases both before and after receiving bilateral electrolytic lesions of the septum or sham surgery. These phases were: (1) competition tests in which a subject and a stimulus male were exposed to a female in an adjacent cage; (2) sexual behavior tests with a female; and (3) 10-day group cage tests in which subjects were in a mixed-sex environment. Aggressive behaviors (chases, threats, beak fences and pecks) were significantly reduced by septal lesions but not by sham surgery. Directed song (courtship) was significantly reduced in sexual behavior tests, with similar trends in other testing phases. Male field sparrows were tested 2 days pre-surgery and 2 days post-surgery in outdoor aviaries placed in their natural habitat. Tests consisted of dawn song observations and observations of courtship and aggression following introduction of a female to the subject's aviary, which was followed 10 min later by the introduction of another male (without removing the female). Septal lesions significantly facilitated both overt aggression (chases) and the number of simple (multi-purpose) songs. These results provide evidence that the septum participates in the regulation of male aggression and song in songbirds, and further suggest that variations in septal function may exist between territorial and colonial species.

Aggression↗
PubMed1999

[Clinical study of six thymic carcinomas including long-term survivors].

Six cases of thymic carcinoma (mean age 48.5 years old, one male and 5 females) were treated in our hospital from September 1990 to September 1998. The histological subtypes of thymic carcinoma were squamous cell in 4, undifferentiated in one, and small cell in one. All cases underwent midsternal thoracotomy, 4 had total resection of the tumor and 2 had exploratory thoracotomy due to tumor invasion of the aorta and the main pulmonary artery. Within 2 years after operation, 2 cases without radiation therapy were died of the carcinoma and one case was died of asthma. However, two cases of squamous cell carcinoma have been alive and disease free for 3 and 5 years since the operation followed by mediastinal irradiation. We think that radiation therapy is very effective to control the disease because one of them underwent only exploratory operation prior to irradiation. Another one case who survives 5 years after total resection of the tumor following irradiation revealed swelling of numerous mediastinal lymph nodes, pathologically consisted of non-caseating epithelioid cell granulomas without metastasis of carcinoma, at the time of operation. These lymph nodes were diagnosed as "sarcoid-like reaction" because there was no clinical evidence of generalized sarcoidosis. The "sarcoid-like reaction" may contribute to the 5-year survival of the patient because it is thought to be a local immune response against the cancer cells. A remaining patient, alive 6 months after total resection of the thymic small cell carcinoma following irradiation, received preoperatively three cycles of the intra-arterial administration using CBDCA via bilateral internal mammary arteries. This induction chemotherapy had no response of the tumor size, but it was considered to have a possibility of reducing the size of thymic carcinoma by the use of other agents (CDDP, VDS etc.) because the tumor was fed mainly by the highly developed internal mammary arteries.

Adult↗
PubMed1999

Effect of septal lesions on male song and aggression in the colonial zebra finch (Taeniopygia guttata) and the territorial field sparrow (Spizella pusilla)

The present investigation assessed the effect of lesions of the septum on male courtship and aggression in the territorial field sparrow (Spizella pusilla) and the colonial zebra finch (Taeniopygia guttata). In addition, pair-bonding and a variety of other social behaviors were examined in the zebra finch and dawn song (both the strictly agonistic song type and the multipurpose song type) was examined in the field sparrow. Zebra finches were tested in three phases both before and after receiving bilateral electrolytic lesions of the septum or sham surgery. These phases were: (1) competition tests in which a subject and a stimulus male were exposed to a female in an adjacent cage; (2) sexual behavior tests with a female; and (3) 10-day group cage tests in which subjects were in a mixed-sex environment. Aggressive behaviors (chases, threats, beak fences and pecks) were significantly reduced by septal lesions but not by sham surgery. Directed song (courtship) was significantly reduced in sexual behavior tests, with similar trends in other testing phases. Male field sparrows were tested 2 days pre-surgery and 2 days post-surgery in outdoor aviaries placed in their natural habitat. Tests consisted of dawn song observations and observations of courtship and aggression following introduction of a female to the subject's aviary, which was followed 10 min later by the introduction of another male (without removing the female). Septal lesions significantly facilitated both overt aggression (chases) and the number of simple (multi-purpose) songs. These results provide evidence that the septum participates in the regulation of male aggression and song in songbirds, and further suggest that variations in septal function may exist between territorial and colonial species.

Aggression↗
PubMed1999

[Complete disruption of thoracic descending aorta without widening of the pseudoaneurysm].

A 41-year-old male was transported to our emergency room 25 minutes after blunt chest trauma. The chest X-ray film and CT scanning demonstrated left pulmonary atelectasis, hemothorax, and widening of mediastinum possibly due to hematoma. Hundred and fifty minutes after arrival to the hospital, we were rush to bring him to the operation theater suspecting serious injury of the thoracic organs in association with bleeding from left thoracic drainage tube without detection of the aortic rupture. The left standard thoracotomy disclosed no injury of the left lung, good continuity and no dilatation of the thoracic descending aorta. But visual blood flow observed through the adventitia of the aortic isthmus led us to the final diagnosis of the aortic rupture. After aortic clamping, the intima of the injured aorta was found to be completely disrupted for a length of 6 cm and was repaired with a vascular prosthesis under the partial cardiopulmonary bypass using a centrifugal pump. His postoperative course was uneventful. We reported a case of complete circumferential aortic rupture without widening of the pseudoaneurysm in the acute stage of the disease.

Adult↗
PubMed1998

[Surgical stabilization of multiple rib fractures successfully achieved with the use of long metalic plates].

Surgical stabilization of multiple rib fractures in 5 male patients was successfully achieved with the use of orthopedic A-O metalic plates, which are called reconstruction plates. In each patient, we prevented deformity of the rib cage and flail chest which frequently occurs after multiple rib fractures. Three of these patients received emergency operations because of severe hemopneumothorax and flail chest due to crushing injuries to the chest. They were treated by the standard thoracotomy, hemostasis of intrapleural bleeding, and stabilization of fractured ribs with reconstruction plates, in addition two of the patients underwent a single lobectomy to control the pulmonary hemorrhage. Another two patients were treated with mechanical ventilation and closed-tube thoracotomy following the chest trauma because their thoracic bleeding from drainage tubes was tolerable. But flail chest and respiratory insufficiency did not improve, in spite of positive controlled ventilation as a mode of internal pneumatic stabilization. Then surgical stabilization of the fractured ribs with these plates was carried out ten to twelve days after the accidents in each case. All patients tolerated the surgical procedures well and were successfully removed from the respirator, demonstrating complete stability of the chest wall. The long metal reconstruction plates with many perforations were very useful for the external fixation of segmentary fractured ribs as an external brace. This was because they were long enough to cover the whole length of the fractured ribs and moderately soft enough to be appropriately bent or twisted by hand at the time of operation. Moreover a number of holes in it allowed the suture to pass through the plate and rib, avoiding displacement of the prosthesis. This is the first report which describes the usefulness of orthopedic reconstruction plates for the stabilization of multiple rib fractures.

Adult↗
PubMed1998

Adrenomedullin in the gastrointestinal tract. Distribution and gene expression in rat and augmented gastric adrenomedullin after fasting.

The aim of this study was to investigate the regional distribution, molecular forms, and gene expression of adrenomedullin in the rat gastrointestinal tract and to examine physiological changes in gastric adrenomedullin after 24-h fasting. The tissue concentration was measured by radioimmunoassay. The molecular forms were analyzed by high performance liquid chromatography. mRNA levels were quantified by Northern blotting and cells positive for adrenomedullin immunoreactivity were localized by immunohistochemistry. A high concentration of adrenomedullin was found in stomach, cecum, and colon (450-520 fmol/g wet tissue). Adrenomedullin immunoreactivity was also detected in duodenum, jejunum, and ileum (200-250 fmol/g wet tissue). Transcripts of the adrenomedullin gene were widely expressed throughout the gastrointestinal tract. The major form of adrenomedullin immunoreactivity in stomach and colon corresponded precisely with authentic adrenomedullin peptide. Adrenomedullin immunoreactive cells were present in the gastrointestinal endocrine system. The concentration and mRNA level of gastric adrenomedullin after fasting were significantly increased compared with findings in controls. Adrenomedullin is ubiquitous in the gastrointestinal tract, and may be produced by endocrine cells. The results suggest that adrenomedullin, through its potent vasodilating activity, may play some role, in the stomach including the regulation of the mucosal blood flow.

Adrenomedullin↗
PubMed1998

Developmental effects on intersexual and intrasexual variation in growth and reproduction in a lizard with temperature-dependent sex determination.

The mechanisms that control growth and reproduction have received considerable attention by molecular and cellular endocrinologists, yet there has been relatively little effort to link these two aspects of physiology. On the other hand, evolutionary biologists have long commented on the relationship between growth and reproduction in many species, yet have generally neglected the mechanisms underlying such complex traits. An approach that integrates the multiple proximate levels promises to provide significant insight into the evolution of neuroendocrine control mechanisms. In this chapter, we take this approach in reviewing environmental influences on growth and reproduction in the leopard gecko, Eublepharis macularius. In this species, incubation temperature during embryonic development not only determines gonadal sex, but also underlies within-sex differences in growth, adult morphology, aggressiveness, reproductive physiology and behaviour, and brain organization. Thus, the leopard gecko is an excellent model to elucidate the developmental interactions among the environment and the endocrine and nervous systems that control growth and reproduction.

Animals↗