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Biomedical subjects

K Kodama

Publications and source records attributed to K Kodama.

At least 415 records · Page 23Linked to original sources
PubMed1992

[Surgical repair of infarct-related ventricular septal perforation using Teflon felt patch].

Eight patients with infarct-related ventricular septal perforation underwent surgical repair using Teflon felt patch. The overall early operative mortality rate was 12% (1/8). One of three patients (33%) with cardiogenic shock preoperatively, one of five patients (20%) operated within 7 days after the onset of infarction died within 30 days after operation. A patient with inferior infarction died early after operation. In 5 of 8 patients (63%), IABP was removed within 24 hours after operation. A patient died due to the recurrence of gastric cancer in late postoperative phase. None of patients was found to have a recurrence of the ventricular septal perforation after the operation. Five of 6 patients (83%) surviving the operation are in NYHA class I or II.

Aged↗
PubMed1992

[Emergent cardiovascular operation in patients older than 75 years].

From January 1988 through December 1990, 7 patients older than 75 years underwent emergent cardiovascular operation. We evaluated those operative results. The mean age was 80.1 years (range 77 to 85 years) and there were 5 men and 2 women. Coronary artery bypass grafting for 2 cases, closure of ventricular septal perforation for 1 case, graft replacement of ascending aorta and suspension of aortic valve in 2 cases, closure of left ventricular free wall rupture (LVFWR) in 1 case and closure of arch aneurysm rupture for 1 case were performed. Operative mortality was 14.3% (1/7). There was one hospital death. Five survivors had uneventful course in early postoperative term, but they needed long elaborate hospital care because of complications in noncardiac general organs in late postoperative term. They need nutritional support, rehabilitation for muscle weakness and so on. Their mean postoperative hospital period was 53 days. All of them were improved in New York Heart Association I or II. We concluded that we attained a good operative result in emergent cardiovascular operation in patients older than 75 years by effective operation as a result of long elaborate postoperative hospital care.

Aged↗
PubMed1992

[Cell kinetics in two cases of meningioma with ultra-late pulmonary metastases].

In order to elucidate the influence of surgical intervention on cell kinetics, we investigated the DNA ploidy pattern and mitotic index in two patients with metastatic pulmonary meningioma more than 10 years after the first operation for primary brain lesions. The first patient, with hemangiopericytomatous meningioma, showed a diploid pattern in all resected specimens and intrathoracic metastases obtained at autopsy, and also showed a constant mitotic indices throughout the clinical course. The second patient, with meningothelial meningioma, also showed a diploid pattern and constant mitotic indices throughout the clinical course. There was no difference in the two parameters between this second patient and 5 non-metastatic control cases. In conclusion, there was no positive correlation between these two parameters and the acceleration of tumor growth detected at every surgical intervention.

Adult↗
PubMed1992

[Usefulness of Nd-YAG laser for the excision of multiple lung metastases and segmentectomy for primary lung cancer].

Since 1986, limited resection of 561 pulmonary metastases in 25 patients was performed with the neodymium:yttrium-aluminum-garnet (Nd-YAG) laser. Use of the laser enabled a local excision of both superficially located and deep-seated tumors that would otherwise have required segmentectomy or lobectomy for safe removal. As a result, the 5-year survival rate for these patients was 40.3%. Since 1988, we also developed laser segmentectomy to treat primary lung cancer, and performed this procedure on 25 lung cancer patients. Of those, twenty-one patients had T1N0 disease. All are alive now and have had no local recurrence. The pulmonary distortion, which leads to impairment and loss of pulmonary function, was minimal in laser resection when compared to other procedures such as stapled resection or the casual ligation-division technique. In conclusion, we have found the Nd-YAG laser to be an effective tool both for preserving pulmonary function and for obtaining clear safety margins.

Adult↗
PubMed1991

In vitro mutagenesis and functional expression in Escherichia coli of a cDNA encoding the catalytic domain of human DNA ligase I.

Human cDNAs encoding fragments of DNA ligase I, the major replicative DNA ligase in mammalian cells, have been expressed as lacZ fusion proteins in Escherichia coli. A cDNA encoding the carboxyl-terminal catalytic domain of human DNA ligase I was able to complement a conditional-lethal DNA ligase mutation in E. coli as measured by growth of the mutant strain at the non-permissive temperature. Targeted deletions of the amino and carboxyl termini of the catalytic domain identified a minimum size necessary for catalytic function and a maximum size for optimal complementing activity in E. coli. The human cDNA was subjected to systematic site-directed mutagenesis in vitro and mutant polypeptides assayed for functional expression in the E. coli DNA ligase mutant. Such functional analysis of the active site of DNA ligase I identified specific residues required for the formation of an enzyme-adenylate reaction intermediate.

Amino Acid Sequence↗
PubMed1991

Primary and metastatic pulmonary meningioma.

Patient 1 was a 53-year-old man who had a very rare primary pulmonary meningioma that developed in the left lingular segment. When this report was written, 7 years had passed since he underwent operation, and no recurrence of the meningioma had been detected. In Patient 2, a 61-year-old woman, multiple pulmonary metastases were confirmed 19 years after she had undergone operation for multiple cerebellar meningiomas, and the metastases were resected. After 2 years, multiple intraperitoneal metastases were found, and thus aggressive surgery was performed. Currently, 22 years after the operation for the primary cerebellar meningioma, the patient is alive without any subjective symptoms, although intraperitoneal metastases have recurred. To date, only four cases (all in women) of primary pulmonary meningioma have been reported. Case 1 reported in this article is thus the first case in a male patient to be reported, and, in addition, this patient also has the first reported case to have been evaluated for more than 5 years. In Case 2, however, each of the excised extracranial tumor lesions was histologically homogeneous and showed a hemangiopericytomatous pattern. The histologic picture of those tumor lesions was exactly the same as the picture of a small portion of the cerebellar meningiomas excised 19 years earlier. Thus, all those extracranial tumor lesions were diagnosed to be metastatic meningiomas. However, it is difficult to explain why there had been no symptoms for as long as 19 years until the pulmonary metastases were discovered.

Cerebellar Neoplasms↗
PubMed1991

Giant metastatic VIPoma in the liver.

A case of giant metastatic liver VIPoma manifesting WDHA syndrome is described. The patient was a 33-year-old Japanese male who was admitted because of persisting watery diarrhea and weight loss. Laboratory examinations revealed marked hypokalemia, mild hypercalcemia and highly elevated plasma vasoactive intestinal peptide (VIP) and glucagon levels. Intensive imaging examinations disclosed two large tumors in the liver but not in other organs, including the pancreas. Laparoscopy disclosed a slightly elevated purplish-colored large tumor on the surface of the apparently normal liver. At operation, however, a small hard nodule was observed in the tail of the pancreas. Histologically, it was revealed to be a VIPoma resembling a carcinoid or an islet cell tumor, and was identical to the liver tumors. Thus, this neoplasm was considered to be a VIPoma of pancreatic origin, with metastatic lesions in the liver.

Adult↗
PubMed1991

Bronchial neurofibrosarcoma.

A 56-year-old woman was seen with the clinical features of collapse of the right lower lobe. Intrabronchial extension of a tumor was demonstrated endoscopically. Sleeve bilobectomy was performed, and a diagnosis of bronchial neurofibrosarcoma was confirmed by light and electron microscopic and immunohistochemical studies.

Bronchial Neoplasms↗
PubMed1991

Establishment and characterization of a new Ewing's sarcoma cell line.

A new human Ewing's sarcoma cell line (CADO-ES1) was established from the malignant pleural effusion of a 19-year-old woman. These cells grew both anchorage dependently and anchorage independently. When cultured in bacteriologic dishes, they grew as tightly packed multicellular tumor spheroids; they were also capable of proliferating in soft agar. Flow cytometric DNA analysis demonstrated a nearly diploid DNA content (DNA index = 0.902). Chromosomal studies of cultured cells showed an isodicentric chromosome 8 in all examined cells, but t(11;22)(q24;q12), a translocation reported previously in Ewing's sarcoma, was not detected. Under normal culture conditions, no morphologic evidence of neural differentiation was detected. In addition, immunocytochemical studies showed that vimentin was intensely positive, whereas neurofilament (NF) and neuron-specific enolase (NSE) were weakly positive. Treatment with cyclic AMP (cAMP) induced pronounced morphologic evidence of neural differentiation and strong expression of NF in cultured cells. S-100 protein, glial fibrillary acidic protein (GFAP), desmin, cytokeratin, and epithelial membrane antigen were not detected immunohistochemically in either untreated or cAMP-treated cells, however. These data suggest that this cell line is derived from a highly undifferentiated neural cell with high chromosomal clonality, differentiating into neural features under certain conditions.

Adult↗
PubMed1991

The incidence of thoracic vertebral fractures in a Japanese population, Hiroshima and Nagasaki, 1958-86.

The incidence of thoracic vertebral fractures (TVF) in a Japanese population of 14,607 individuals from Hiroshima and Nagasaki was determined by sex, age, birth cohort, and exposure to atomic bomb radiation. The diagnosis of TVF was based on lateral chest radiographs made from 1 July 1958 to 28 February 1986. The subjects, who were born between 1880 through 1939, were categorized by sex into 10-year birth cohorts. TVF incidence increased by a factor of 1.7 in all birth cohorts with each 10-year increase in age in females, but did not increase with age in males. The incidence was significantly lower in the younger birth cohorts in both sexes. The incidence declined by a factor of 0.5 in males and 0.6 in females for each 10-year decrease in the year of birth. TVF incidence did not differ between the cities, and no correlation with atomic bomb radiation exposure was demonstrated.

Adult↗
PubMed1991

Effects of coronary angioplasty on left ventricular diastolic filling in patients with old myocardial infarction: a study with pulsed Doppler echocardiography.

To examine the effects of percutaneous transluminal coronary angioplasty (PTCA) on left ventricular diastolic filling in patients with an old myocardial infarction, transmitral flow velocity pattern was measured using pulsed Doppler echocardiography before and after PTCA for the peak early diastolic filling velocity (E) and the ratio of the early diastolic filling to peak atrial filling velocities (E/A ratio) in 73 patients with coronary artery disease. These patients were classified into three groups: 34 patients without previous myocardial infarction (no MI group), 16 patients with an old myocardial infarction in whom a non-infarct-related vessel was reperfused by PTCA (MI-1 group), and 23 patients with an old myocardial infarction in whom the infarct-related vessel was reperfused by PCTA (MI-2 group). The degree of improvement in left ventricular diastolic filling was calculated using the values before PTCA as controls. The % increases in E and E/A ratio were 20 +/- 15 and 25 +/- 19%, respectively, in the no MI group and 27 +/- 20 and 18 +/- 16%, respectively, in the MI-1 group and there was no significant difference between these groups. The % increases in E and E/A ratio in the MI-2 group were 7 +/- 19 and 6 +/- 17%, respectively, and were significantly (P less than 0.05) less than those in the no MI and MI-1 groups. An increase in E, E/A ratio or both by 20% or more was observed in 21 of the 34 (62%) patients of the no MI group, in 10 of the 16 (63%) patients of the MI-1 group and in six of the 23 (26%) patients of the MI-2 group. Thus, reperfusion of a non-infarct-related vessel in patients with an old myocardial infarction improves left ventricular diastolic filling to the same degree and with the same frequency as in patients without myocardial infarction.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1991

Kindling-induced changes of [3H]GTP binding in the cerebral cortical membrane.

Specific [3H]GTP binding to the cerebral cortical membrane was examined in amygdaloid kindled rats. Membrane fractions of the cerebral cortex obtained from kindled rats and sham operated control were incubated with [3H]GTP and the data were analyzed by Scatchard plots. There were no differences in the Bmax and Kd values in basal (without any agonists) binding between kindled and control membranes. In the presence of isoprenaline, beta-agonist, Bmax values increased in the control, but did not increase in the kindled group. The kindling-induced abolishment of isoprenaline effect on Bmax of GTP binding persisted at least two weeks. Specific GTP binding activity of control membrane increased in the presence of carbachol, muscarinic agonist. A carbachol-induced increase in specific GTP binding activity also disappeared in the kindled group. These results suggest that a functional imbalance among various types of GTP binding proteins (Gs, Gi or Go) might be related to the acquisition of the epileptogenesis in the kindling model of epilepsy.

Amygdala↗
PubMed1991

Magnetic resonance imaging in children with spastic diplegia: correlation with the severity of their motor and mental abnormality.

Magnetic resonance imaging (MRI) findings for 34 children with spastic diplegia, examined between two and 10 years of age, were analysed. Dilatation of the trigone, atrophy of the peritrigonal white matter and prominent deep cortical sulci were seen. On T2-weighted images, periventricular high-intensity areas in the white matter adjacent to the trigones and bodies of the lateral ventricles were seen in many children. These MRI features may reflect the pathological changes of periventricular leukomalacia in children with spastic diplegia. Among the MRI findings, only the amount of white matter correlated with severity of disability: white matter reduction corresponded to the more severe motor disabilities.

Brain↗
PubMed1991

Leg movements in the supine position of infants with spastic diplegia.

Leg movements in the supine position of 49 infants with spastic diplegia (three to 11 months corrected age) were examined. Only simultaneous flexion and extension of the hips and knees were seen, with exceptional isolated hip movements; the simultaneous movements had synergic features. When the knees were flexed, the hips were flexed, abducted and externally rotated, and the ankles were dorsiflexed. When the knees were extended, the hips were extended, adducted and internally rotated and the ankles were plantar-flexed. Hip flexion combined with knee extension (leg elevation) and isolated knee movements were not seen in diplegic infants, but were seen in all control preterm infants with a good prognosis, after five and six months corrected age, respectively. The absence of these movements is a useful diagnostic item for spastic diplegia.

Cerebral Palsy↗
PubMed1991

[Three cases of human fascioliasis].

Three patients with hepatic fascioliasis are presented. (case 1) A 36-year-old female was admitted in January, 1988, because of intermittent high-grade fever. Laboratory findings included white blood cell count 8,050/mm3 with 29% eosinophils, and CRP 9.5 mg/dl. There was a positive intradermal reaction to Fasciola hepatica antigen. Liver biopsy revealed eosinophilic abscess, granulation and many Charcot-Leyden crystals. (case 2) A 54-year-old male was admitted in June, 1985, because of abdominal fullness. Marked hepatomegaly was noticed. Laboratory findings included white blood cell count 10,200/mm3 with 26% eosinophils, and CRP 2.2 mg/dl. (case 3) A 48-year-old male was admitted in March, 1989, because of intermittent high-grade fever. Hepatomegaly was noticed. Laboratory findings included white blood cell count 7,310/mm3 with 30.3% eosinophils, and CRP 3.5 mg/dl. His condition was complicated by pleuritis with invasion of Fasciola hepatica. In all patients, stool specimens were negative for ova and immunoelectrophoresis was positive for F. hepatica antigen. Computed tomography demonstrated multiple low-density areas in the periphery of the liver in cases 1 and 3, and disseminated areas in case 2. After treatment with bithionol 40 mg/kg every other day for 40 days, all three patients became asymptomatic.

Adult↗
PubMed1991

Randomized trial of a selective inhibitor of thromboxane A2 synthetase, (E)-7-phenyl-7-(3-pyridyl)-6-heptenoic acid (CV-4151), for prevention of restenosis after coronary angioplasty.

A selective inhibitor of thromboxane A2 synthetase, CV-4151, has the unique property of increasing prostacyclin synthesis in addition to its anti-platelet aggregating effect. Prostacyclin inhibits the growth of smooth muscle cells which is considered to be an underlying mechanism of restenosis occurring after successful coronary angioplasty. A prospective randomized trial was conducted to determine whether CV-4151 could prevent restenosis. Administration was begun greater than or equal to 2 days before angioplasty, and continued until the follow-up study performed between 3 and 6 months after angioplasty. Follow-up angiography was performed in 58 patients (81 segments) taking the active drug and in 27 patients (35 segments) taking the placebo. The incidence of angiographic restenosis was 38.3% in the former group and 31.4% in the latter group. Thus, CV-4151 did not significantly reduce the incidence of restenosis, perhaps due to endothelial denudation after angioplasty preventing an increase of the subendothelial local prostacyclin level.

Angioplasty, Balloon, Coronary↗
PubMed1991

Evaluation of right ventricular function using gated equilibrium blood pool radionuclide ventriculography in patients with congenital volume and pressure overload late after surgical repair.

The effects of congenital right ventricular pressure and volume overload were studied in 3 patients with pulmonary stenosis, 7 with atrial septal defect and 6 with atrial septal defect plus pulmonary stenosis late after successful surgical correction. Gated equilibrium blood pool radionuclide ventriculography was used to measure right ventricular function at rest and during exercise and to compare it with eight normal subjects. Right ventricular ejection fractions at rest and during exercise were measured to be 61 +/- 9% and 66 +/- 13%, respectively, in the group with pulmonary stenosis, 49 +/- 7% and 54 +/- 8% in the group with atrial septal defect, and 65 +/- 13% and 69 +/- 13% in the group with atrial septal defect plus pulmonary stenosis. The values in the groups with pulmonary stenosis and atrial septal defect plus pulmonary stenosis were significantly higher than the control subjects (45 +/- 5% and 51 +/- 5%, p less than 0.01). The peak filling rate at rest and during exercise was also significantly higher in the groups with pulmonary stenosis and atrial septal defect plus pulmonary stenosis than in controls (at rest, 2.72 +/- 0.72, 2.53 +/- 0.94 vs. 1.64 +/- 0.24 p less than 0.05; during exercise, 4.38 +/- 1.23, 4.13 +/- 1.18 vs. 2.52 +/- 0.62, p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗