Biomedical subjects

K Kodama

Publications and source records attributed to K Kodama.

At least 181 records · Page 10Linked to original sources

PubMed1998

Increased circulating soluble form of Fas in patients with dilated cardiomyopathy.

To examine the prognostic role of the circulating soluble form of Fas (sFas), circulating sFas levels were measured in 33 patients with dilated cardiomyopathy (DCM) and 12 age-matched normal control subjects (NC) using an enzyme-linked immunosorbent assay (ELISA). Circulating sFas levels in DCM were significantly higher than those in NC (2.42+/-1.02 vs 1.66+/-0.20 ng/ml, p=0.015). Patients with DCM were stratified into 2 groups [group I (n=15): sFas > or =2.06 ng/ml; group II (n=18): sFas <2.06 ng/ml] on the basis of the mean value plus 2SD of circulating sFas level in NC. The circulating sFas level was significantly increased in relation to the severity of heart failure and correlated positively to left ventricular end-diastolic pressure in DCM. However, there were no significant differences in left ventricular dimension between the 2 groups. There were 5 deaths from worsening heart failure in group II, but there were no deaths in group I during the follow-up period. In conclusion, circulating sFas levels were increased in patients with DCM. Circulating sFas levels are increased in proportion to the severity of heart failure and may provide prognostic information independent of left ventricular geometry.

Cardiomyopathy, Dilated↗

PubMed1998

Relation between coronary blood flow and left ventricular mass in hypertension: noninvasive quantification of coronary blood flow by thallium-201 myocardial scintigraphy.

This study was conducted to quantify coronary blood flow (CBF) noninvasively according to the fractionation principle and to elucidate the relation between CBF and left ventricular hypertrophy. CBF/cardiac output (CO), estimated on the basis of the ratio of myocardial uptake/total injected dose of thallium-201 (% cardiac uptake), was determined in 14 control subjects and 40 patients with essential hypertension. CBF and CBF per 100 g of myocardium (unit CBF) were calculated according to the following formulas: CBF= % cardiac uptake x CO, and unit CBF = (CBF/LVM) X 100, where CO and left ventricular mass (LVM) are echocardiographically determined. There was good reproducibility of % cardiac uptake (r = 0.983, p < 0.0001). Percent cardiac uptake was greater in hypertensive patients (4.65+/-1.44%) than in control subjects (3.64+/-0.64%), and there was a positive correlation between % cardiac uptake and LVM. CBF (ml/min) was greater in hypertensive patients (240.7+/-80.5) than in control subjects (194.9+/-36.9), but unit CBF (ml/min/100 g) was less in hypertensive patients (102.2+/-26.7) than in control subjects (150.3+/-30.5). Multiple regression analyses showed that LVM was the most potent independent predictor of resting CBF in hypertension. Our results indicate that CBF, determined by thallium-201 myocardial scintigraphy, increases parallel to the increase in LVM, but unit CBF decreases even in the resting condition in patients with essential hypertension.

Adult↗

PubMed1998

Snow on cholera--the special lecture in the Second British Epidemiology and Public Health Course at Kansai Systems Laboratory on 24 August 1996.

The Second British Epidemiology and Public Health Course was held from 19 to 25 August 1996 in Osaka as a satellite meeting for the 14th International Scientific Meeting of the International Epidemiological Association. Thirty-three researchers from 10 countries participated in the course. Professor Walter W Holland gave a special lecture about Snow on cholera during the course, and the lecture revealed that Henry Whitehead who was a junior priest at that time contributed to Snow's work to prevent the cholera outbreak in Golden Square in 1854. What John Snow did in his life are reviewed in detail in this paper.

Cholera↗

PubMed1998

Relationship between the level of activities of daily living and chronic medical conditions among the elderly.

The purpose of this study is to observe the disease-disability association through a cross-sectional study. Between 1994 and 1995, we conducted a questionnaire survey in 5 towns in Japan. Among the items included in the questionnaire, 5 related to ADL (bathing, feeding, dressing/undressing, toileting, and going out socially) were treated as purpose variables; and 5 related to the history of medical treatment received over the past year (diabetes, heart disease, cerebrovascular disease, neuralgia, and bone fractures) were used as explanatory variables. Multiple logistic models were applied to observe the relationship. The history of medical treatment for cerebrovascular disease greatly and unavoidably affects disability related to ADL. Bone fractures, diabetes, and heart diseases contributed to specific ADL disabilities.

Activities of Daily Living↗

PubMed1998

Immunological characteristics of the effector cells induced by a combination therapy with cyclophosphamide and allogeneic lymphocytes.

A significant inhibition of tumor growth was observed when sarcoma 180 (S180)-bearing ICR strain mice were treated by a combination therapy, with a low dose of cyclophosphamide (CY) and an inoculation of allogeneic lymphocytes collected from C57BL/6 mice. The growth-inhibitory effect was significantly increased by an inoculation of a relatively lower dose of allogeneic lymphocytes (1 x 10(5) cells) and CY. The effector cells induced in the mice treated with CY and allogeneic lymphocytes expressed the Lyt 1.2, Lyt 2.2, IL-2R antigens on their membrane surface and did not express the H2KbDb (donor H-2) antigen, and they showed a specific cytostatic activity against S180 cells. These results strongly suggested that a combination therapy with a low dose of CY with an inoculation of allogeneic lymphocytes augmented an induction of specific cytotoxic T lymphocytes in the tumor-bearing recipient mice.

Animals↗

PubMed1998

[An elderly patient with bleeding from the alimentary tract caused by aberrant pancreas of the small intestine].

A 71-year-old woman was admitted to hospital because of malaise and bloody stool. Laboratory findings consistently showed anemia (Hb 9.2 g/dl) and occult blood in the stool. Although barium series and endoscopy of the upper and lower intestinal tructs were carried out, there was no evidence of bleeding from the gastrointestinal tract 99mTcO4- scintigraphy, which was performed to exclude bleeding from Meckel's diverticulum, also did not locate a significant lesion. Angiographic imaging of the superior mesenteric arteries (SMA) was performed to exclude lesions such as small intestine tumors with extraluminal growth and vascular abnormalities such as A-V malformation and it revealed the round encasement of arteries in the peripheral SMA region, strongly suggestive of a small intestine tumor. Surgery was performed and an extraluminally protruding tumor was found in the small intestine. The excised tumor was 4 x 3 x 3.5 cm in size, are was diagnosed histologically as aberrant pancreas. The postoperative laboratory findings showed that the anemia had improved and occult blood was not detected in the stools. Although aberrant pancreas of the small intestine is a common benign tumor, it is a very unusual cause of bleeding from the alimentary tract.

Aged↗

PubMed1998

B-90063, a novel endothelin converting enzyme inhibitor isolated from a new marine bacterium, Blastobacter sp. SANK 71894.

A novel endothelin-converting enzyme (ECE) inhibitor, B-90063, was isolated from the culture supernatant of the newly discovered marine bacterium Blastobacter sp. SANK 71894. Based on spectral analyses and chemical reactions, the structure of B-90063 was determined to be bis[6-formyl-4-hydroxy-2-(2'-n-pentyloxazol-4'-yl)-4-pyridon -3-yl]-disulfide (1a). Human and rat ECEs were inhibited more potently by B-90063, with respective IC50 values of 1.0 and 3.2 microM, than were other neutral endopeptidases such as NEP and type-I and -IV collagenases. B-90063 also inhibited the binding of ET-1 to rat ET(A) and bovine ET(B) receptors, though its antagonistic activities were weak. B-90063, thus, may abolish the physiological actions of endothelins through the ECE inhibitory and receptor antagonistic mechanisms.

Animals↗

PubMed1998

[Intrapulmonary arterial injection of Albunex for left heart contrast echocardiography].

Contrast enhancement of the left heart cavity and myocardium were assessed after venous injection of the ultrasound contrast agent Albunex. Myocardial perfusion was also assessed using a drug stress and image analyzing system. The study population consisted of 46 patients with normal cardiac function and without coronary artery disease, and 38 patients with effort angina. Contrast echocardiography was performed by imaging the parasternal or apical long-axis view during pulmonary arterial injection of Albunex through a Swan-Ganz catheter. Contrast enhancement in the left ventricular cavity and ascending aorta were visually assessed. Hemodynamic, arterial blood gas and electrocardiography changes were recorded before and after the injection of Albunex. Contrast echocardiography was performed before and during intravenous infusion of dipyridamole to assess left ventricular myocardial enhancement by both visual inspection and peak background-subtracted gray level using an image analyzing system. Doppler flow signal change after the injection of Albunex was assessed in 26 patients using a Doppler guide wire located in the left anterior descending coronary artery. Good contrast enhancement was obtained in all patients in the left ventricular cavity and in 17% of patients in the ascending aorta. No significant changes were observed in hemodynamics, electrocardiograms and aortic gas analysis. Significant myocardial enhancement was not seen in any patient but gray level analysis of the echo images during dipyridamole infusion showed significant enhancement in 25% of the patients without coronary artery disease and in 34% of the patients with effort angina. Doppler flow signal in the coronary artery was significantly augmented in all patients after injection of Albunex and suggests that ultrasound contrast agent reaches coronary arteries in all patients regardless of myocardial contrast enhancement. Contrast echocardiography with pulmonary arterial injection of Albunex is safe and useful to obtain sufficient left ventricular contrast enhancement. For myocardial perfusion assessment, further refinement of the ultrasound contrast agent and echo equipment is necessary.

Adult↗

PubMed1998

[Morphological studies on lower margins of nasal aperture in the skull of Hokkaido Japanese].

It is well-known that the lower margins of nasal aperture in the human skull may be classified into the following four types, i.e., Forma anthropina, Forma infantilis, Fossae praenasales and Clivus nasoalveolaris, and that the rates of appearance of these four types differ with races. In the present study we made morphological studies on the lower margins of nasal aperture of 465 Hokkaido Japanese skulls, 463 skulls with symmetrical nasal aperture and 2 skulls with asymmetrical one, and compared the findings with those of all races in the world, especially of the Japanese, Ainu, Moyoro Man, Hamanaka Site Man and Eskimo. Forma anthropina was found in 330 skulls (71.27 +/- 2.10%) among the 463, marking the highest rate. Forma infantilis, found in 74 skulls (15.98 +/- 1.70%) among the 463, marked the second highest rate. Fossae praenasales, found in 42 skulls (9.07 +/- 1.33%) among the 463, marked the third highest rate. These 42 cases of Fossae praenasales were further classified into three types, i.e., sub-Forma infantilis, 17 (40.48%), typical Fossae prenasales, 23 (54.76%) and sub-Clivus nasoalveolaris, 2 (4.76%). Clivus nasoalveolaris, found in 17 skulls (3.67 +/- 0.87%) among the 463, marked the lowest rate. As a whole, the rates of the four types in the Hokkaido Japanese were close to those in the other groups of the Japanese in Kinai and Hokkaido (Ito).

Adult↗

PubMed1998

Radiation therapy among atomic bomb survivors, Hiroshima and Nagasaki.

As a follow-up to the two previous surveys of radiation therapy among the atomic bomb survivors, a large-scale survey was performed to document (1) the number of radiation therapy treatments received by the atomic bomb survivors and (2) the types of radiation treatments conducted in Hiroshima and Nagasaki. The previous two surveys covered the radiation treatments among the Radiation Effects Research Foundation Adult Health Study (AHS) population, which is composed of 20,000 persons. In the present survey, the population was expanded to include the Life Span Study (LSS), including 93,611 atomic bomb survivors and 26,517 Hiroshima and Nagasaki citizens who were not in the cities at the times of the bombings. The LSS population includes the AHS population. The survey was conducted from 1981 to 1984. The survey teams reviewed all the medical records for radiation treatments of 24,266 patients at 11 large hospitals in Hiroshima and Nagasaki. Among them, the medical records for radiation treatments of 1556 LSS members were reviewed in detail. By analyzing the data obtained in the present and previous surveys, the number of patients receiving radiation therapy was estimated to be 4501 (3.7%) in the LSS population and 1026 (5.1%) in the AHS population between 1945-1980. During 1945-1965, 98% of radiation treatments used medium-voltage X rays, and 66% of the treatments were for benign diseases. During 1966-1980, 94% of the radiation treatments were for malignant neoplasms. During this period, 60Co gamma-ray exposure apparatus and high-energy electron accelerators were the prevalent mode of treatment in Hiroshima and in Nagasaki, respectively. The mean frequency of radiation therapy among the LSS population was estimated to have been 158 courses/year during 1945-1965 and 110 courses/year during 1966-1980. The present survey revealed that 377 AHS members received radiation therapy. The number was approximately twice the total number of cases found in the previous two surveys. Thus the data on radiation therapy in the AHS members have been updated well by this survey, and will provide information for more precise dose-response analyses of radiation effects in the AHS population. The information extracted from the medical records of the hospitals consisted of hospital names, treatment periods, body sites treated, diagnoses, treatment doses, radiation sources, the field sizes of the exposures and the data for identification of the patients. These data will be essential in estimating the organ doses from scattered radiation and in evaluating the effects of therapeutic radiation.

Adolescent↗

PubMed1998

[Comprehensive approach to cerebral palsy: changes of concept in Japan].

Cerebral palsy is associated not merely with impairments of posture and locomotion, but also with various other problems. Medical illnesses should be treated by an adequate system. Emotional disturbances require a psychological support. Communication disorders may be overcome with proper modern equipments Perceptional deficits and sensory impairments should also be addressed. Care systems for physically handicapped children in Japan were established by the concept of ryoiku, a term in Japanese created about fifty years ago by K. Takagi, Professor of the Department of Orthopedics, University of Tokyo. This term can hardly be translated into English, bot in my view stands for a comprehensive approach comprising orthopedic treatments, educational programs and vocational trainings. Based on this concept, Dr. Takagi founded an institution for the physically handicapped in 1942; followed by establishment of similar institutions in all areas of Japan after World War II. Despite its historical role, ryoiku does not meet any more the current standard of care for cerebral palsy. We need now a new comprehensive term and management systems. A novel medical subdivision "medicine for developmental handicaps" may also be necessory. In this paper I made an overview of current problems of children and adults with cerebral palsy. I proposed a new concept of ryoiku and emphasized the need for the new medicine to treat developmental handicaps.

Adult↗

PubMed1998

[Does induction therapy followed by surgery improve the survival rate in limited-stage small-cell lung cancer patients?].

Small-cell lung cancer (SCLC) is distinguished from non-small cell lung cancer (NSCLC) by its rapid tumor doubling time, high growth fraction, and early development of widespread metastases. Surgery alone offers the best chance for long-term survival in selected patients with stage I SCLC. Most patients with limited SCLC (stage I-IIIa) are treated with "comprehensive therapy" combined with chemotherapy, radiotherapy (thoracic radiotherapy and/or prophylactic cranial irradiation), and surgery. Although the efficacy of surgery in the control of local disease is well established, to date no report has shown better survival rates in patients who receive induction therapy when compared with patients receiving postoperative chemotherapy. However, studies of induction therapy include more patients with advanced-stage cancer than do studies of post-operative chemotherapy. Thus the final role of induction therapy followed by surgery must await the results of future prospective, randomized trials conducted by large cooperative study groups.

Carcinoma, Non-Small-Cell Lung↗

PubMed1998

Marked attenuation of mitral regurgitation by stent implantation: a patient with unstable angina.

A 69-year-old woman was admitted because of increase of chest pain and dyspnea. Systolic murmur of Levine III/VI was heard. Electrocardiography showed ST depression caused by ischemia. Echocardiography revealed severe mitral regurgitation (MR) and inferoposterior hypokinetic wall motion. Left ventriculography revealed the presence of MR (II/IV). Coronary angiography showed severe organic stenosis of the right coronary artery. Based on these findings, the diagnosis was severe papillary muscle dysfunction caused by unstable angina. The lesion of the right coronary artery was successfully stented with a Palmaz-Schatz stent. During balloon inflation, the v wave of the pulmonary capillary pressure curve was greatly elevated. After the stent implantation, ST depression was normalized and MR improved dramatically. Therefore, we suppose that acute MR was induced by temporary papillary muscle dysfunction, and could be relieved with coronary angioplasty.

Aged↗

PubMed1998

[Simultaneous operation of lung cancer accompanied with aortic arch aneurysm: report of a case].

We report a simultaneously operated case of a 68-year-old man with lung cancer accompanied with aortic arch aneurysm. Preoperative staging CT for lung cancer incidentally demonstrated another lesion in the para-aortic arch area, which was suspected to be rather a pleural or intrapulmonary lesion by enhanced CT and MRI. However, this lesion was intraoperatively diagnosed as a cystic small sized-aneurysm. After a left upper lobectomy with lymph node dissection for lung adenocarcinoma (T2N0) was performed, this aneurysm was tightly wrapped using PTFE felt during the course of one operation. The difficulty of peroperative diagnosis by CT and MRI for small sized-aneurysm is discussed, and surgical stragety for lung cancer accompanied with such an aortic aneurysm is also commented.

Adenocarcinoma↗

PubMed1998

Flow cytometry measurements of subsets of T, B and NK cells in peripheral blood lymphocytes of atomic bomb survivors.

Previous studies of blood cells from atomic bomb survivors have shown that frequencies of chromosome aberrations and somatic mutations are elevated in heavily exposed survivors and that T-cell functions and the number of mature T cells are decreased in the survivors who were exposed to radiation as adults. Current progress in flow cytometry allows a sophisticated analysis of various subsets of T, B and NK cells. In the present study, proportions of such subsets in peripheral blood lymphocytes from atomic bomb survivors (159 survivors estimated to be exposed to > or =1.5 Gy) and 252 controls were measured using multiple combinations of monoclonal antibodies to lymphocyte differentiation antigens to investigate whether the previous radiation exposure had altered the composition of the subsets. Among T-cell subsets, the proportion of CD4+ T-cell subsets was decreased significantly in the heavily exposed survivors; this tendency was apparent for the CD4+CD45RA+ naive T-cell subset. However, there were no significant differences in the proportions of CD8+ T-cell subsets between the exposed survivors and controls. As for the B-cell subsets, the proportion of both CD5+ and CD5 B cells as well as CD23+ and CD23- B cells increased in the heavily exposed survivors. Further, no effect of radiation was found in the proportion of NK-cell subsets. These results strongly suggest that previous radiation exposure altered the composition of T and B cells in the peripheral blood of atomic bomb survivors, and they raise the possibility that atomic bomb radiation may have affected the developmental processes of T and B cells.

Adult↗

PubMed1998

[Ramsay Hunt syndrome associated with eosinophilic pneumonia].

A 66-year-old woman was admitted to the hospital because of dry coughing. Ten days before admission, the patient had suffered from facial palsy accompanying otic zoster infection (Ramsay Hunt syndrome). Acyclovir was given, and during the two weeks after admission, the facial palsy resolved completely. The dry coughing worsened, and marked eosinophilia developed (1.930/mm3). A chest roentgenogram and a computed tomogram revealed wandering non-segmental infiltration in the left lung field. Examination of a specimen obtained by transbronchial lung biopsy revealed moderate eosinophilic infiltration into thickened alveolar septa and alveolar spaces. An elevated CD 4/CD 8 ratio (4.12) and a high level of eosinophilic cationic protein (8.730 micrograms/l) were found in bronchoalveolar lavage fluid. Eosinophilic pneumonia was diagnosed. The patients condition improved without medication within one month after the onset of the dry coughing. Laboratory results revealed no parasitic or mycotic infection, and both an acyclovir skin test and a lymphocyte stimulation test were negative, which suggested that the pneumonia had been induced by an allergic reaction to unknown antigens resulting from Th 1/Th 2 imbalance after reactivation of varicella-zoster virus latent in sensory ganglia.

Aged↗

PubMed1998

[Surgical treatment of T3N0M0 non-small cell lung cancer].

From January 1982 to June 1995, 45 patients underwent operation at our department for T3N0M0 non-small cell lung cancer. Tumors invaded chest wall in 38 patients (parietal pleura in 17, subpleural fat tissue in 10, and rib in 11), diaphragm in 3, mediastinum in 3, and pericardium in 1. Extrapleural dissection was performed in 17 patients and en bloc resection of chest wall and lung was performed in 21. Complete resection was possible in 43 patients (96%). Operative mortality was 2.2%. The actuarial overall 5-year survival rate was 63% for the patients with parietal pleura invasion, 45% for those with subpleural invasion, 45% for those with rib invasion, and 56% for those with diaphragm, mediastinal pleura or pericardial invasion. Recurrence at the resected margin was observed in 5 patients with chest wall invasion (subpleural tissue in 3, rib in 2) and 1 with diaphragmatic invasion. In conclusion, we recommend an en bloc resection of the chest wall with enough surgical margin for peripheral tumors firmly adherent to the parietal pleura.

Adult↗

PubMed1998

[Complications after treatment of acute coronary syndrome].

The rupture of the unstable plaque and the thrombus formation caused the occlusion of the coronary artery and followed myocardial ischemia and/or myocardial necrosis, then resulted in clinical worse outcome. The reopen of the occluded artery is the most important things for the treatment of acute coronary syndrome, and there are usually two established ways to open the occluded artery. Thrombolysis and angioplasty are already established ways to reopen, however has some complications, that is, failure to reopen, reocclusion, and bleeding. Angioscopic observations reveal the mechanism underlying these complications and suggest that platelet rich white thrombus formation continues until a month after the onset and unstable yellow plaques exist until 18 months after the onset. The most problems for the treatment in today are the unaware of the mechanism of the occlusion. If the thrombus is the major mechanism for the occlusion, thrombolytic therapy must be chosen. If the plaque is the major occlusive mechanism, the angioplasty must be chosen. To reveal the mechanisms underlying the coronary artery occlusion, we will have to use the angioscope instead of coronary angiography. After we will be able to clarify the occlusive mechanism by angioscope, we will reduce the dosage of thrombolytic agents and resulted in the decrement of bleeding complications and reopen the coronary artery effectively without complications.

Acute Disease↗