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Biomedical subjects

K Fujioka

Publications and source records attributed to K Fujioka.

At least 73 records · Page 4Linked to original sources
PubMed1994

[Ehlers-Danlos syndrome with impending ruptured thoracic descending aortic aneurysm in a young adult--a case report].

We here report on a rare case of Ehlers-Danlos syndrome type IV with impending ruptured thoracic aortic aneurysm in a young adult. A 38-year-old man complained of severe back pain and transient paralysis in both legs. He was diagnosed as having an impending ruptured thoracic descending aortic aneurysm. Emergency operation which was aneurysmectomy and reconstruction of the descending aorta was performed. The fact that the aneurysm (11 cm) in a patient was so large for his age and the abnormal subcutaneous fatty tissue suggested the existence of systemic metabolic disease. An analysis of collagen extracted from the patient revealed the absence of type III collagen. Furthermore, an electron microscopic analysis finding that the collagen fibrils was of non-uniform size lead to the diagnosis of Ehlers-Danlos syndrome, Type IV (arterial type). Postoperatively the patient suffered paralysis in both legs due to ischemia of the spinal cord. However, his general condition was stable. He was transferred to another hospital for rehabilitation of both legs 60 days after the operation. Although the physical signs usually associated with Ehlers-Danlos syndrome were absent in this case, diagnosis followed electrophoresis of collagen extracted from the patient. As a result of the above observation, we recommended analysis of collagen in cases where the size of the aneurysm or the age of the patient appear unusual even though physical signs of Ehlers-Danlos syndrome are absent.

Adult↗
PubMed1993

Targeted recombination with single-stranded DNA vectors in mammalian cells.

We studied the ability of single-stranded DNA (ssDNA) to participate in targeted recombination in mammalian cells. A 5' end-deleted adenine phosphoribosyltransferase (aprt) gene was subcloned into M13 vector, and the resulting ssDNA and its double-stranded DNA (dsDNA) were transfected to APRT-Chinese hamster ovary cells with a deleted aprt gene. APRT+ recombinants with the ssDNA was obtained at a frequency of 3 x 10(-7) per survivor, which was almost equal to that with the double-stranded equivalent. Analysis of the genome in recombinant clones produced by ssDNA revealed that 12 of 14 clones resulted from correction of the deletion in the aprt locus. On the other hand, the locus of the remaining 2 was not corrected; instead, the 5' deletion of the vector was corrected by end extension, followed by integration into random sites of the genome. To exclude the possibility that input ssDNA was converted into its duplex form before participating in a recombination reaction, we compared the frequency of extrachromosomal recombination between noncomplementary ssDNAs, and between one ssDNA and one dsDNA, of two phage vectors. The frequency with the ssDNAs was 0.4 x 10(-5), being 10-fold lower than that observed with the ssDNA and the dsDNA, suggesting that as little as 10% of the transfected ssDNA was converted into duplex forms before the recombination event, hence 90% remained unchanged as single-stranded molecules. Nevertheless, the above finding that ssDNA was as efficient as dsDNA in targeted recombination suggests that ssDNA itself is able to participate directly in targeted recombination reactions in mammalian cells.

Adenine Phosphoribosyltransferase↗
PubMed1993

Sequential bypass for multisegmental occlusive disease.

We evaluated the effectiveness of a sequential bypass for multisegmental occlusive disease. Forty-seven multiple bypass grafts were performed on 43 patients ranging in age from 55 to 83 years (mean: 70 years). The indications for operation included incapacitating claudication in 20 limbs, resting pain in 15, and nonhealing ulcers in 12. An anatomical arterial bypass was performed on 36 limbs, consisting of an aorto-femoro-popliteal bypass in 21 limbs, a femoro-popliteal-posterior tibial bypass in 8, an ilio-femoro-popliteal bypass in 4, an ilio-femoro-posterior tibial bypass in 2, and a femoro-popliteal-plantar bypass in 1. Similarly, an extra-anatomical arterial bypass was performed on 11 limbs, consisting of an axillo-femoro-popliteal bypass in 6, a crossover femoro-femoro-popliteal bypass in 3, an axillo-femoro-posterior tibial bypass in 1, and a crossover femoro-femoro-anterior tibial bypass in 1. The follow-up period ranged from 3 to 77 months (mean: 23 months). Twelve graft failures occurred, and 2 of them required major amputations. The cumulative graft patency rate was 85% at one year and 65% at 3 years. Arterial Doppler examination revealed a mean preoperative ankle-brachial index of 0.29 +/- 0.25. The early and late mean postoperative ankle-brachial indices, however, increased to 0.97 +/- 0.19 and 0.84 +/- 0.25, respectively. Midterm results have indicated that such multiple sequential bypass grafts are effective.

Aged↗
PubMed1993

Arterial reconstruction in elderly patients.

The surgical results of primary peripheral arterial reconstruction for arteriosclerosis obliterans during a 16-year period were examined as a function of age. Data in group 1 were of 121 procedures performed on 95 patients aged > or = 70 years and those in group 2 of 215 procedures performed on 148 patients aged < or = 69 years. There was no significant difference between the operative mortality rate of 4% (four of 95) in group 1 and 3.4% (five of 148) in group 2. The long-term mortality rate was 33% (31 of 95) in group 1, significantly higher (P < 0.05) than 18.9% (28 of 148) in group 2. The most common cause of death in both groups was cardiac failure. Cumulative 5-year survival rates in groups 1 and 2 were 56.3 and 78.3% respectively (P < 0.0001). The cumulative primary 5-year patency rates of suprainguinal bypass grafts in the two groups were 94.2 and 90.4%, respectively, while those of infrainguinal reconstruction were 67.7 and 55.0% respectively. The 5-year cumulative limb salvage rate was 93.1% in group 1 and 92.7% in group 2. None of these differences was significant. The results support an active approach to surgery in elderly patients with peripheral arterial obstruction caused by arteriosclerosis obliterans.

Adult↗
PubMed1993

[High-dose busulfan, VP-16 and ACNU therapy with stem cell transplantation for the treatment of children with acute leukemia].

In order to strengthen the anti-leukemia effect, we developed a new conditioning regimen with high dose busulfan, VP-16 and ACNU (BVA) for cytoreduction before stem cell transplantation. Fourteen patients with refractory acute leukemia received allogeneic bone marrow transplantation (BMT) or peripheral blood stem cell transplantation (PBSCT) after conditioning with the BVA regimen, 7; allogeneic BMT, 1; syngeneic BMT, 6; PBSCT. # Seven patients were transplanted in the first complete remission, and 8 patients were in their second or third remission. Although total body irradiation or cyclophosphamide was not included in this regimen, engraftment was obtained in all cases. Two patients suffered relapse, and one patient died of cytomegalovirus interstitial pneumonitis (IP) 64 days after PBSCT. The other 11 patients are alive and free of disease at a median follow up time of 647 days (98-1235 days). Major regimen-related toxicity was pulmonary complications such as IP (3 cases) and pulmonary edema (2 cases). However, all patients recovered rapidly following steroid therapy. The results indicate that this conditioning regimen is highly effective for the treatment of childhood acute leukemia.

Acute Disease↗
PubMed1993

Effects of rhubarb tannins on renal function in rats with renal failure.

The effects of tannins purified from Rhei Rhizoma on various parameters of renal function were investigated in rats with adenine-induced renal failure. The glomerular filtration rate, renal plasma flow and renal blood flow were significantly increased in rats given (-)-epicatechin 3-O-gallate at a dose of 5 or 10 mg/kg body weight/day for 24 days. Administration of 5 mg of procyanidin B-2 3,3'-di-O-gallate also led to a significant increase in renal functional parameters. However, unlike the former two components, procyanidin C-1 3,3',3''-tri-O-gallate caused aggravation of renal function.

Adenine↗
PubMed1993

Abdominal obesity is associated with insulin resistance.

BACKGROUND: Recent evidence suggests that insulin resistance and hyperinsulinemia may account for many of the medical complications of obesity. This study was performed to determine whether a predominance of body fat in the abdominal region is associated with insulin resistance and hyperinsulinemia. METHODS: Two groups of nine obese women were matched for age and total obesity but differed significantly in the pattern of fat distribution as defined by the waist-to-hip circumference ratio (WHR). The high-WHR group had a WHR of 0.87 (+/- 0.01), and the low-WHR group had WHR of 0.77 (+/- 0.02) (P < .05). RESULTS: Plasma levels of glucose, free fatty acids, and insulin, measured hourly for eight hours while the subjects consumed a diet of regular food, were higher in the high-WHR group. CONCLUSION: The high-WHR group (abdominal obesity) was more resistant to the action of insulin. These results suggest that measurement of the WHR could help define the degree of medical risk for a given obese patient seeking treatment.

Abdomen↗
PubMed1993

[Treatment and prognosis after late relapse in childhood acute lymphoblastic leukemia].

We evaluated the clinical courses and laboratory features in 13 late-relapse cases of 55 children with acute lymphoblastic leukemia who had been in complete remission for longer than their years. In 8 of 13 cases, leukemia relapsed in bone marrow; 2 with testicular, 1 with central nervous system and one with ovarian involvement. Further, extramedullary relapse not involving bone marrow occurred in 5 cases (4 testicular and 1 CNS). Late-relapse was more frequently observed in boys (37.5%) than in girls (4.4%). Initial age and leukocyte counts were of no value in predicting late-relapse. The relapse rate in cases initially treated by the VPL regimen was twice that of those by a multi-drug regimen. A second prolonged remission was achieved in 5 of 10 cases by combinations of intensive chemotherapy (modified HEX) and irradiation to the testes or CNS. On the contrary, all late relapse patients initially treated by the multi-drug chemotherapy had a poor outcome. More intensive chemotherapy, including high-dose chemoradiotherapy and bone marrow transplantation, should be employed in this group of patients.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1992

Protective effect of NGF atelocollagen mini-pellet on the hippocampal delayed neuronal death in gerbils.

Very recently, contradictory results were presented as to the effects of exogenous nerve growth factor (NGF) on the hippocampal delayed neuronal necrosis following transient ischemia. In the present study, we administered a large amount of NGF with the atelocollagen mini-pellet system, measured the local NGF contents, and evaluated the effect of this neurotrophic factor on the postischemic hippocampal pyramidal cells in gerbils. We concluded that the exogenous NGF, when given continuously at sufficient concentrations, prevents pyramidal cell damage. The possible cause of discrepancy in previous studies is discussed.

Animals↗
PubMed1992

Swimming-associated cryptosporidiosis.

In July and August 1988, an outbreak of gastroenteritis affected 44 of 60 (73%) persons from 5 separate swimming groups who had used the same swimming pool in Los Angeles. Cryptosporidium was identified in 5 of 8 (63%) stool specimens, and the clinical picture was consistent with Cryptosporidium infection. Resistance of Cryptosporidium to chlorine, an inadequately maintained pool filtration system, repeated exposure to pool water, and possible continuing pool contamination may have contributed to ongoing transmission. Cryptosporidium should be considered a potential etiologic agent of gastroenteritis associated with recreational water use.

Adolescent↗
PubMed1992

[Cystic disease of right popliteal artery with spontaneous resolution].

The case was 50-year-old man. He was admitted to our hospital suffering from intermittent claudication. DSA and CT showed stenosis of the right popliteal artery due to compression by the tumor like lesion. The adventitial cystic disease was suggested. Three weeks later he had no symptom. DSA and CT revealed no reappearance of the adventitial cystic disease. The popliteal adventitial cyst spontaneously decreased in size. It is a very rare case.

Angiography, Digital Subtraction↗
PubMed1992

Fluoxetine treatment of the obese diabetic.

Fluoxetine, an inhibitor of serotonin re-uptake, has been shown to cause weight loss in humans and animals. In order to determine the effects in diabetic subjects, 48 male and female, obese, type 2 non-insulin dependent diabetics being treated with insulin were randomized to receive fluoxetine 60 mg or placebo once daily in double blind fashion for 24 weeks. In all subjects, this treatment was preceded by four weeks and followed by six weeks of single blind placebo washout treatment. Subjects performed daily home glucose monitoring and were given instruction in a 1200 kcal American Diabetes Association diet. Fluoxetine treated subjects who completed the trial (n = 16) lost more weight than placebo treated subjects (n = 20) (9.3 +/- 2.4 vs. 1.9 +/- 2.9 kg +/- s.e.m, P less than 0.05). Subjects in the fluoxetine group also showed a greater percentage decrease in insulin dose than those in the placebo group (46.9 +/- 7.6% vs. 19.3 +/- 7.6%, P less than 0.01). During active treatment, the change in serum glucose levels did not differ between the two groups, while glycohemoglobin fell more in fluoxetine treated subjects than in placebo treated subjects at two of four follow-up visits. These results suggest that fluoxetine may be of benefit in the treatment of obese patients with type 2 non-insulin dependent diabetes mellitus.

Adult↗
PubMed1992

A randomized double-blind clinical trial of fluoxetine in obese diabetics.

Fluoxetine is an inhibitor of serotonin re-uptake which has been found to produce weight loss in humans and animals. To test the effects of this drug in obese diabetic subjects, 48 male and female, obese type II non-insulin dependent (NIDDM) diabetics who were being treated with insulin were randomized to receive either fluoxetine 60 mg or a placebo once daily in a randomized double-blind fashion for 24 weeks. A four week single-blind placebo lead-in period preceded and a six week single-blind placebo period followed the double-blind treatment period. Subjects performed daily home glucose monitoring and were given instruction in a 1200kcal American Diabetic Association (ADA) diet. Subjects treated with fluoxetine achieved a maximum 8 kg greater weight loss on average than the placebo-treated subjects. At the end of active treatment, fluoxetine-treated subjects had significantly lower glycohaemoglobin levels than the placebo-treated group (9.72 vs. 10.76%, P < 0.05). In addition, fluoxetine-treated subjects showed a greater decrease in total daily insulin dose than placebo-treated subjects (44.5 vs. 20.1% decrease at the end of active treatment, P < 0.05). These results suggest that fluoxetine may be of benefit in the treatment of obese patients with type II non-insulin dependent diabetes mellitus.

Blood Glucose↗
PubMed1992

[The fate of patients with intermittent claudication-comparison of surgical and non-surgical treatment].

The purpose of this study was to determine the operative indication for patients with intermittent claudication because of arteriosclerosis obliterans, and to compare the late result of the surgical treatment group (182 cases, 250 limbs) with that of the non-surgical treatment group (35 cases, 43 limbs). There were 3 operative deaths and 34 late deaths in the surgical group, and 14 late deaths in the non-surgical group. The number one cause of death was heart failure, including ischemic heart disease, in both groups. The 4-year cumulative patency rates were 91% in the aorto-iliac, 71% in the femoro-distal and 79% in the aorto-femoro-distal arterial reconstructions. Long term symptom free rates of the surgical group and the non-surgical group, except fatal case, were 83% and 44% in the aorto-iliac, 79% and 27% in the femoro-distal, 87% and 33% in the aorto-femoro-distal arterial regions, respectively. Late result of intermittent claudication in the surgical group was better than that in the non-surgical group. We concluded that intermittent claudication should be considered to be the indication for surgery, except for the cases with high risk diseases or malignant diseases.

Aged↗