[Effect of calyculin A on the contraction of colonic smooth muscle of guinea pigs].
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Animals↗
Biomedical subjects
K Ohara
Publications and source records attributed to K Ohara.
[Surgical treatment of rheumatic tricuspid valve disease].
The rheumatic tricuspid valve is relatively rare in this country. We report the study on surgical treatment of 27 patients with rheumatic tricuspid valve. Surgical procedure on 7 cases out of them was tricuspid valve replacement (TVR) with bioprosthesis and tricuspid valvuloplasty (TVP) was performed in the remaining 20 cases. There were two operative deaths in TVR group, however, there were no major complications, such as thrombosed valve, the valve dysfunction or prosthetic valve endocarditis in the remaining five cases after the operation. The method of TVP in twenty cases consisted of two Kay's TAPs, six tricuspid commissurotomies (OTC), ten OTC with Key's TAPs and two OTC with DeVega's TAPs. Doppler cardiography (DCG) revealed residual tricuspid regurgitation (TR) more than 3/4 degrees in 7 cases of TVP group immediately after operation. Moreover, the increment of residual TR was seen in 7 cases during the following period and TVR was performed in 3 cases out of these 7 cases. In conclusion, it is suggested that TVR may be preferred to TVP for the rheumatic tricuspid valve because of severe residual TR in many cases of TVP group.
Bioprosthesis↗
[Comparative analysis of long-term results with porcine-aortic, bovine pericardial and tilting disc valves].
The three series with the first-generation valve prostheses were reviewed for long-term clinical evaluation in isolated aortic and mitral valve replacement. Hancock porcine xenograft was implanted in 71 patients from 1977 to 1979, ionescu-Shiley pericardial xenograft (standard model) in 271 patients from 1979 to 1983, and Bjork-Shiley tilting disc valve in 194 from 1978 to 1986. In aortic position, no any significant difference among three valve types could be demonstrated in the actuarial survival and freedom from thromboembolism and valve infection, while the actuarial freedom from valve dysfunction in lonescu-Shiley valve was significantly lower than that in other two valves. Björk-Shiley valve in mitral position showed satisfactory clinical performance in terms of valve-related complications and survival in comparison with two types of bioprosthetic valves. In our conclusion at present time, Björk-Shiley valve is suitable for the first choice of both aortic and mitral valve prostheses. In case of valve replacement with a bioprosthesis, however, porcine aortic valve is a better choice for aortic, and bovine pericardial valve likely for mitral replacement.
Aortic Valve↗
[Physiopathology and classification of eating disorders].
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Adolescent↗
[Comparative analysis of mechanical and biological prosthetic valves after isolated valve replacement--cooperative study on total 1281 patients].
A total of 1281 patients (594 aortic and 687 mitral) received 734 mechanical valves (320 Björk-Shiley, 283 SJM and 131 Omniscience) and 547 biological (259 ionescu-Shiley, 227 Hancock, and 61 Carpentier-Edwards) were analyzed for postoperative valve dysfunction and thromboembolism. The actuarial survival rates (free from late cardiac deaths and valve-related deaths) were 88.6% (11 years) for mechanical mitral and 86.0% (11 years) for biological mitral valves, and 91.7% (16 years) and 88.5% (12 years), for mechanical and biological aortic valves, respectively. There were no significant differences among these groups. Actuarial rates of freedom from valve-related events were 88.7% (11 years) and 51.7%, for mechanical and biological mitral valves, respectively. There was significant difference between the two types of valves in over 7 years after surgery. In contrast, there were no significant differences between mechanical and biological aortic valves. Actuarial rates of freedom from valve dysfunction were 97.6% (11 years) for mechanical and 56.5% (12 years) for biological mitral valves. The net 12 year results showed no significant differences between the two types of mitral prosthetic valves, but a significantly increased rate of valve dysfunction in the biological mitral valves compared with the mechanical in over 6 years of the study. Concerning AVR, there were no significant differences in the incidence of valve dysfunction between mechanical and biological aortic valves. Actuarial rates of freedom thromboembolism were 92.3% (11 years) and 93.8% (11 years) for mechanical and biological mitral valves, respectively. There were no significant differences between the two types of mitral prosthetic valves.(ABSTRACT TRUNCATED AT 250 WORDS)
Aortic Valve↗
[Effects of ceftriaxone on severe infectious complications in hematological disorders. Tohkai Research Group on Infections in Hematological Disorders].
Ceftriaxone (CTRX), a new long acting antibiotic in the 3rd generation cephem group, was administered intravenously once or twice a day in daily doses of 1-6 g for at least 3 days to 86 patients with severe infections complicating hematopoietic disorders. Underlying diseases were acute leukemia in 41 cases, chronic leukemia in 3 cases, malignant lymphoma in 19 cases, myeloma in 7 cases and others. Most patients (55 cases) suffered from sepsis or suspected sepsis. As for efficacy rates classified by underlying diseases, the treatment was effective in 61.0% of patients with acute leukemia. As for efficacy rates classified by infections, the treatment was effective in 60.0% of patients with sepsis. No side effects were noted except rash in 2 patients. Abnormal hepatic functions were recognized in 3 patients but were not attributed to the agent in any case. The results indicate that CTRX is a safe and useful antibiotic for the treatment of severe infections accompanied by hematopoietic disorders.
Bacterial Infections↗
Pancreatic alpha- and beta-cell function and metabolic changes during oral L-alanine and glucose administration: comparative studies between normal, diabetic and cirrhotic subjects.
The present study investigated whether or not, in addition to the oral glucose tolerance test, oral alanine loading was a useful diagnostic tool for hormonal and metabolic diseases. Fifty g of L-alanine was administered orally in 14 normal, 12 diabetic, and 8 liver cirrhotic subjects. The influence of oral alanine loading on hormones and metabolites was compared with the results of 100 g oral glucose loading. The results obtained were as follows: 1) In the normal subjects and cirrhotics, lactate and pyruvate concentrations gradually increased with time and reached their peak levels at 60 min, whereas they remained unchanged throughout the course in the diabetic group at glucose loading. 2) Alanine administration accelerated ureogenesis but did not affect blood glucose levels. 3) In both glucose and L-alanine administration, free fatty acid, glycerol and ketone body levels declined nonspecifically in all groups. 4) Serum glucagon levels during L-alanine loading increased in all groups, especially in liver cirrhotics. 5) L-alanine was a potent stimulus for insulin secretion in diabetics, while no insulin release during glucose loading was observed. 6) The molar ratio of insulin levels (during glucose loading)/glucagon levels (during L-alanine loading) was a good indicator of systemic glucose homeostasis from the hormonal aspect. It is suggested that, in addition to the oral glucose tolerance test, the oral administration of L-alanine can be a useful tool for the diagnosis of the status in diabetes mellitus and cirrhosis.
Administration, Oral↗
[Protective effects of ulinastatin on hepatic oxygen metabolism during halothane anesthesia in the presence of graded hypoxic hypoxemia].
Hepatic oxygen metabolism and the hepatic energy charge were assessed in mongrel dogs receiving 40,000 U.kg-1 of ulinastatin intra-portally during 2 MAC halothane anesthesia combined with graded hypoxic hypoxemia (21-6% oxygen) for the purpose of evaluating the role of ulinastatin in protecting the liver against the deprivation of the hepatic energy charge resulting in halothane-induced hepatotoxicity. Hepatic blood flow was measured using electromagnetic flowmetry; hepatic oxygen delivery and consumption were calculated from measured hepatic blood flow and oxygen content in hepatic arterial, portal venous and hepatic venous blood. In the animals who received ulinastatin during halothane anesthesia (the UST group), nine out of ten survived even at 8% oxygen, whereas six out of eight died in the halothane-alone group. There was no significant difference in total hepatic blood flow between the two groups. PaO2 was higher in the UST group than the halothane-alone group at 15 and 12% oxygen. Therefore hepatic oxygen delivery was significantly higher in the UST group at 15 and 12% oxygen. Hepatic oxygen consumption and the delivery/consumption ratio were also higher in the UST group at the various inspired oxygen levels. The arterial ketone body ratio, which indicates the mitochondrial energy charge level, significantly decreased with the progress of hypoxia in both groups, but it was significantly higher in the UST group at 8% oxygen.(ABSTRACT TRUNCATED AT 250 WORDS)
Anesthesia, Inhalation↗
[Clinical experience with sulbactam/ampicillin in the pediatric field].
Sulbactam/ampicillin (SBT/ABPC) was given intravenously to 20 children with the following acute bacterial infections; 14 cases of pneumonia, 2 cases of purulent cervical lymphadenitis and 1 case each of bronchitis, pyothorax, cellulitis, and purulent meningitis. Good clinical responses were obtained in 18 out of 20 patients, and bacteriologically, all of the 14 isolated strains were eradicated. No side effect was observed except 2 cases of eosinophilia, and 1 case each of loose stool and elevated thrombocyte. From the above clinical results, it is apparent that SBT/ABPC is a useful antibiotic for the treatment of pediatric patients with various kinds of bacterial infections.
Age Factors↗
[Results of tricuspid valve replacement using xenograft bioprostheses].
Thirty-two cases of tricuspid valve replacement were done with bioprostheses during the period from 1979 to 1986 at our institution. In these cases there were 19 cases of acquired valvular diseases, 10 cases of congenital types of heart diseases and other 2 cases were another genesis. Seven different kinds of bioprostheses were utilized: 30 were bovine pericardial xenografts and 2 were porcine xenografts. In postoperative hemodynamic study, right ventricular end-diastolic pressure and right atrial pressure significantly decreased after tricuspid valve replacement. RV ejection fraction were reduced but there was no statistic significance when compared to the preoperative data. There were 5 patients who showed postoperative atrio-ventricular block and two of them needed permanent pacemaker implantation. Six patients died in postoperative period and other 3 died in late follow-up period. However, these was no mortality directly related to prosthetic valvular failure. In follow-up study, there was no episode of valve thrombosis nor pulmonary embolism. Prosthetic endocarditis was not encountered during this observation period. One patient showed mild degree of tricuspid regurgitation who had severe pulmonary hypertension even after the operation. Based on our experience, we concluded that the bovine pericardial xenograft may be the best choice for the TVR because of its anti-thrombogenicity. However, mechanical valve will be better choice for the patients who are complicated with severe pulmonary hypertension.
Adult↗
[A case of RAEB in transformation successfully treated by low-dose Ara-C treatment].
A 65-year-old male admitted to the Anjo Kosei Hospital due to pancytopenia. The findings at the time of admission were; leukocyte count 2,000/microliters, erythrocyte count 1,580,000/microliters, and platelet count 88,000/microliters. Bone marrow specimen revealed mild hypocellularity with 26% of the blast cells. He was diagnosed RAEB in transformation. Chromosome analysis showed 46, XY, -7, +8, -17, + marker in three cells and 45, XY, -7, -17, + marker in two cells out of five cells. He was treated with the low-dose Ara-C (20mg/body s.c. injections every 12 hrs) for 9 days. Twenty five days later, the blast cells in the bone marrow decreased to 4%, and the complete remission was obtained. The duration of remission is 27+ weeks. At the time of complete remission, the bone marrow cells showed the normal karyotype. In this case, the effect of low-dose Ara-C to the blast cells may have not resulted from induction of differentiation but cytocydal action.
Aged↗
[The continuous-DCMP therapy for acute nonlymphocytic leukemia in elderly patients--comparison with younger patients].
Twenty seven previously untreated patients of acute nonlymphocytic leukemia with age ranging from 30 to 77 years, received a 7-day remission induction regimen consisting of daunorubicin, cytosine arabinoside, 6-mercaptopurine and prednisolone (continuous-DCMP). Patients who achieved complete remission were given ten courses of consolidation therapy and followed without any maintenance therapy. The complete remissions were obtained in 7 of 15 patients (46.6%) 60 years and older, and in 11 of 12 patients (91.7%) 30-59, years of age. Although a high mortality during periods of marrow hypoplasia after the intensive induction therapy, and early relapses in the 60 years and older patients remain major problems, our data suggest the elderly patients deserve a trial of intensive combination chemotherapy.
Adult↗
[Follow-up study of coronary artery bypass grafting after Kawasaki disease--early and late postoperative evaluation].
In our hospital, 22 patients with severe coronary arterial lesion after Kawasaki disease underwent coronary artery bypass grafting (CABG) since 1982. The age of the cases at surgery ranged from 1 year to 19 years. Mean age was 8.3 years. Fifteen cases were bypassed using internal mammary artery (IMA) and 5 cases using IMA and autologous saphenous vein (SVG). Two cases were bypassed using only SVG. They have been examined until now by catheterization, by Treadmill test, and by Tl-201 myocardial imaging, around 1 month (Study 1) and around 1 year (Study 2) after surgery for the evaluation of results of CABG. One patient died from acute myocardial infarction 3 months after surgery and one patient shows return of anginal attack due to graft stenosis. Other patients are almost uneventful. In the study 1,20 (100%) IMA were patent, and 7 (88%) SVG were patent. In the study 2, 11 (92%) IMA and 6 (67%) SVG remained patent. Development of left anterior descending artery distal to IMA anastomosis was shown in 8 cases in the study 2. On the follow-up study with TI-201 myocardial imaging, disappearance or decrease of perfusion defect was seen in 7 cases (59%) in the study 1 and 9 cases (75%) in the study 2. On the Treadmill test, disappearance or improvement of ischemic change was seen in 15 cases (88%) in the study 1 and 10 cases (84%) in the study 2. These results suggest that IMA is more preferable for than SVG for young children who has an indication of CABG after Kawasaki disease.
Adolescent↗
[Late onset of angina pectoris after coronary bypass surgery].
The repeat of angina pectoris of 598 patients with undergoing coronary bypass surgery during the years Jan. 1978 to Aug. 1987 was analyzed. The 5-year and 8-year survival rate was 88% and 84%, respectively. The 5-year and 8-year cardiac event free ratio was 91% and 83%, respectively. The 5-year and 8-year angina free ratio was 73% and 64%, respectively. The causes of repeat angina were graft occlusion in 42%, incomplete revascularization in 16%, progression of native coronary lesions in 28% and unknown in 14%, respectively. PTCR in 4 patients, PTCA in 8 patients and re-CABG in 8 patients were performed to relief from angina pectoris.
Adult↗
[Clinical experience with cefodizime in pediatric field].
Cefodizime (CDZM, THR-221) was given intravenously to 20 children with the following acute bacterial infections: 2 cases each of tonsillitis, bronchitis, purulent cervical lymphadenitis, and urinary tract infections and 12 cases of pneumonia. Good clinical responses were obtained in 18 patients out of the 20, and bacteriologically, all of the 5 strains identified were eradicated. No side effect was obtained except one case of eosinophilia. From the above clinical results, it is apparent that CDZM is a useful antibiotic for the treatment of pediatric patients with various kinds of bacterial infections.
Age Factors↗
Aqueous flare and cell measurement using laser in endogenous uveitis patients.
We verified the applicability of the newly developed laser aqueous flare-cell meter in 124 consecutive patients with endogenous uveitis. The flare intensity was expressed in equivalent bovine serum albumin concentration and the number of cells per 0.075 mm3 of the aqueous humor. A comparison between the laser flare-cell readings and conventional slit-lamp gradings indicated a linear correlation between the two findings for aqueous flare. There was a correlation between the two findings for the aqueous cells, but the relationship seemed nonlinear, and the aqueous cell readings remained low except for severe aqueous cells graded as 3+ in slit-lamp grading. The measurement of the aqueous flare with the present apparatus was found to be highly useful in assessing the degree of anterior uveitis, but the cell counts need a careful interpretation.
Adolescent↗
[Late cardiac events of coronary bypass surgery].
The cardiac events of 598 patients undergoing coronary bypass surgery were analyzed. The hospital and late death was 4.9% and 3.8%, respectively. The late death were caused by cardiac events in 7 patients and non-cardiac events in 16 patients. Of 7 cardiac death, 5 patients were died of acute myocardial infarction (AMI), and 2 patients were died of congestive heart failure. 5-year survival rate, 5-year event free ratio, and 5-year non-cardiac event free ratio were 88%, 70% and 91%, respectively. Of 18 patients who suffered from AMI after operation, 5 patients died. The causes of AMI were grafts occlusion in 9 patients, progression of coronary lesions in 5 patients and unknown in 4 patients. PTCR, PTCA and rebypass surgery were performed in 4, 9 and 8 patients, respectively.
Adult↗
[Surgical management of concomitant diseases of coronary and cerebral arteries--indication and late results].
Among 632 patients with isolated coronary artery bypass graftings (CABG), 77 patients had coexisting symptomatic or asymptomatic cerebrovascular diseases (group A). The other 555 patients had not concomitant cerebrovascular diseases (group B). Surgical and late mortality rate in group A and group B were 7.8%, 5.2%, and 6.4%, 3.6%, respectively. The late mortality rate in group A was significantly higher than those in group B. The cerebrovascular accident (CVA) rate in group A and group B were 5.2% and 1.3% in perioperative period, and 18.2% and 3.6% in late stage, respectively. The complication ratio of CVA after CABG were significantly higher in group A than those in groups B. In conclusion, the best surgical approach to the patients with combined coronary artery and cerebrovascular diseases who indicated CABG and extracranial to intracranial bypass graftinges (ECICG) were suggested as follows: 1) CABG is the first staged operation, if cerebrovascular disease is clinically stable. 2) ECICG for cerebrovascular disease is the first staged operation, if angina pectoris is clinically stable. 3) ECICG should be started in the first stage under the assist with IABP if both diseases in the crisis, and wait few days to perform CABG in the second stage, if possible. The simultaneous approach of CABG and ECICG should be the last of choice.
Cerebral Revascularization↗