[Diaphragmatic hernia].
Explore the source record for details and available documents.
Diagnosis, Differential↗
Biomedical subjects
K Okabe
Publications and source records attributed to K Okabe.
[Experimental study on the effects of hypothermic perfusion by extracorporeal membrane oxygenation].
It is important to determine the optimal conditions of extracorporeal membrane oxygenation (ECMO) for the treatment of diseased lung with severe acute respiratory failure. The purpose of this study is to evaluate the effects of hypothermic perfusion by ECMO. Veno-venous ECMO was performed in 13 mongrel dogs. The blood drainage catheter was inserted into the right atrium through the right external jugular vein and the blood return catheter was inserted into the left femoral vein. The temperatures of the priming solution and the heat exchanger were adjusted to 33 degrees C for Group A (n = 6) and 37 degrees C for Group B (n = 7). Before starting ECMO and at 10, 30, 60, 120, 180, and 300 minutes after starting ECMO, the pulmonary arterial blood temperature and the esophageal temperature were measured and the blood samples were obtained from the abdominal aorta. The leukocyte count, platelet count, leukotriene B4 (LTB4) level, vitamin E level and total hemolytic complement (CH50) level were determined. The pulmonary arterial blood and esophageal temperatures approached about 33 degrees C in Group A and about 37 degrees C in Group B at 60 minutes of ECMO and remained stable until the end of ECMO. The leukocyte count did not change significantly in Group A, but was significantly elevated in Group B at 60, 120, 180, and 300 minutes of ECMO when compared with before ECMO. The leukocyte count in Group A was significantly lower than that in Group B at 120, 180, and 300 minutes of ECMO. There were no significant differences between the platelet counts of the two groups. The LTB4 level was always lower than before ECMO in Group A, and was always higher than before ECMO in Group B.(ABSTRACT TRUNCATED AT 250 WORDS)
Acute Disease↗
Serum and tissue measurements of CA72-4 in ovarian cancer patients.
Serum levels of cancer-associated antigen 72-4 (CA72-4) (tumor-associated glycoprotein 72; TAG-72) from 106 patients with primary ovarian cancer were measured by an immunoradiometric assay employing the monoclonal antibodies (MAbs) B72.3 and CC49. Immunohistochemical localization of TAG-72 was also investigated using immunoperoxidase methodology in conjunction with both light and electron microscopy. In using a cutoff value of 4.0 U/ml for the serum assay, sensitivity of all primary ovarian carcinomas was 63.2% (67.6% of mucinous cystadenocarcinomas and 66.7% of serous cystadenocarcinomas), while specificity of benign ovarian tumors was 91.1%. Diagnostic characteristics of CA125 and CA72-4 have been demonstrated by receiver-operating-characteristics analysis. Although CA125 expressed a remarkable diagnostic efficiency with serous cystadenocarcinoma, it was less efficient with mucinous cystadenocarcinoma. CA72-4, however, was highly detectable for any histological type of ovarian cancer. Immunohistochemical staining with MAbs B72.3 and CC49 in the cytoplasm was stronger than that in the cell membrane in tissues from mucinous cystadenocarcinomas. Also, histological localization of TAG-72 in the microvilli and apical cytoplasmic membrane was demonstrated by electron microscopy using MAb B72.3 and samples of seromucinous cystadenocarcinoma (mixed type). Consequently, TAG-72 was useful for the detection of ovarian carcinoma, especially for monitoring mucinous cystadenocarcinoma, and it is localized in the microvilli and apical cytoplasmic membrane of cystadenocarcinoma cells.
Adenocarcinoma↗
Biodegradable poly(DL-lactic acid) formulations in a calcitonin delivery system.
A synthetic analogue of eel calcitonin, [Asu1, 7]-ECT, was incorporated into biodegradable poly(DL-lactic acids) with number-average molecular weights (Mn) of 1400-4400 by the melt-pressing technique. The in vitro release of drug from a parabolically degradable poly(DL-lactic acid) with Mn = 1400 showed an initial burst release and completed the release in 3 d from the start of the test. The drug release from a Mn = 4400 polymer with an S-type degradation pattern was kept at 14 +/- 5 units/d for an experimental period of 24 d.
Amino Acid Sequence↗
Clinical significance of measuring plasma concentrations of glutamine and glutamate in alcoholic liver diseases.
We investigated the significance of assaying plasma glutamine and glutamate concentrations in various liver diseases. Comparison was made with an aminogram in non-alcoholic liver disease. In alcoholic liver diseases, the plasma glutamate concentration showed a statistically significant elevation compared to the value in non-alcoholic liver diseases. In contrast, the plasma glutamine concentration was elevated in non-alcoholic liver diseases but showed no elevation in alcoholic liver diseases. The glutamate (Glu)/glutamine (Gln) ratio and plasma gamma-GT level correlated well in patients of alcoholic liver diseases. The Glu/Gln ratio became normal after alcohol abstinence. The results suggest that measuring the plasma concentrations of glutamine and glutamate may be a useful method to estimate the pathophysiological state of patients with alcoholic liver diseases.
Acute Disease↗
Ethanol and hydrazine sulfate induced chronic hepatic injury in rats: the curative effect of administration of glucogenic amino acids.
There is a widespread belief that when ethanol is fed to rats for a long time, it produces only fatty degeneration without necrosis or fibrosis. In this study, hydrazine sulfate, an inhibitor of low Km ALDH and gluconeogenetic enzymes, was fed with ethanol to rats, and produced more serious pathological changes compared with those found in Lieber's model. Male Sprague-Dawley rats were fed with a low fat liquid diet as a basal diet with ethanol (4%, w/v) and hydrazine sulfate for 4 weeks. At the end of the experiment, plasma aminotransferase levels were found to be elevated. Histological examination showed not only fatty degeneration but also pericellular fibrosis. Therefore, we have evaluated the curative effect of glucogenic amino acids, alanine and glutamine, on this hepatic injury model and found them to be partially protective.
Alanine Transaminase↗
Studies on the incidence of hepatocellular carcinoma in heavy drinkers with liver cirrhosis.
The incidence of hepatocellular carcinoma (HCC) in heavy drinkers who drank more than 130 g per day for more than 10 years, and non-drinkers with cirrhosis who were positive or negative hepatitis C virus (HCV) markers, was analyzed in order to evaluate the effect of a large amount of alcohol on the development of HCC. A parallel study was also conducted in some patients from the aspect of HCV genotypes. Among 57 heavy drinkers with liver cirrhosis, HCV marker was positive in 36 patients (C+Al group) and negative in 21 patients (Al-alone group). Eighty-one patients with liver cirrhosis of non-drinkers were positive for HCV markers (C-alone group). HCV infection was involved in 63% of heavy drinkers with cirrhosis and 44% of patients with HCC. The majority of HCC patients in the C+Al group was infected with HCV through routes other than blood transfusion. HCC developed at a younger age in patients of the C+Al group than in patients of the C-alone group without relation to history of blood transfusion. In more than a third of patients who had tattoos or used stimulants in the C+Al group, HCC developed without a history of blood transfusion. These results suggest that heavy drinking enhances the development of HCC. The HCV genotypes in patients with HCC were all type II, except for one case of type III and one unclassified. The mixed type of HCV was often found in patients who had a blood transfusion or tattoo, suggesting that there may be some correlation between the routes of HCV infection and the diversity of genotypes.
Adult↗
Assessment of emaciation in relation to threat to life in anorexia nervosa.
Twenty patients with anorexia nervosa and a body weight below 60% of the standard weight were studied. One died of starvation; the others survived. Four patients, including the deceased, had such severe weakness that they could not sit up without support, and another five could sit up only from a lateral position. Serum albumin or hemoglobin levels at the beginning of therapy could not be used for nutritional assessment because of dehydration, while increased blood urea nitrogen was associated with acute illness. The present results together with data from previous studies of fatal anorexia indicate that the risk of mortality may be quite low when body weight is above 60% of the standard. We suggest that gross muscle weakness in addition to body weight for height can be a valuable indicator to assess the criticalness in anorexia nervosa.
Adolescent↗
Thoracic duct cyst of the mediastinum. Case report.
A mediastinal thoracic duct cyst was incidentally found in an asymptomatic 45-year-old man. The cyst, 6 cm in diameter, was soft and unilocular, with an extremely thin wall, and contained chyle. It was successfully excised.
Humans↗
[Effect of rG-CSF on the morphology and function of neutrophils in ovarian cancer chemotherapy].
The combined use of rG-CSF in ovarian cancer chemotherapy prevents a decrease in the number of neutrophils and promotes their recovery. rG-CSF also protects against infections, enhancing chemotherapeutic effectiveness. It is reported that neutrophils produced by rG-CSF not only increase in number but also in function. Some clinicians, however, doubt whether neutrophils mobilized or produced by rG-CSF have sufficient ability to function practically in clinical cases. We therefore examined, by means of flow cytometry, the neutrophils' phagocytosis and bactericidal ability and we found both normal. No morphological abnormalities were seen in these neutrophils. In our observations, moreover, no effect was exerted on the leukocyte-membrane antigen. It was concluded that (a) rG-CSF was very effective in protecting against the diminution of neutrophils by chemotherapy and (b) in promoting their recovery, and (c) also the function, morphology and leukocyte-membrane antigen of these neutrophils were normal.
Adolescent↗
[Extended resection for lung cancer].
Of the 740 patients with primary lung cancer operated on at our department between January, 1982 and December, 1991, 108 (14.6%) underwent extended operation involving combined resection of adjacent organs. The 5-year survival rates in patients who underwent resection of the parietal pleura (n = 62), thoracic wall (n = 25), diaphragm (n = 11), left atrium (n = 7), superior vena cava (n = 6), and aorta (n = 5) were 13.8%, 20.5%, 14.9%, 0%, 51.4%, 0%, and 20.0%, respectively. Surgical treatment for stage III advanced lung cancer is controversial, but the 5-year survival rates in those who underwent combined resection of the parietal pleura, thoracic wall including the ribs, left atrium, and aorta were not lower than that in all patients with stage III lung cancer. Especially, long-term survivals of 5 years and 11 months and 10 years and 6 months were obtained in patients who underwent resection of the left atrium, and 6-year survival was observed in a patient who underwent resection of the aorta, suggesting that extended resection is effective in some cases. The outcome of combined resection of the diaphragm and the superior vena cava was poor, with no patients surviving for 5 years.
Adult↗
[Thirty-eight operative cases of mediastinal cyst: with particular reference to bronchogenic cyst].
Thirty-eight patients (16 males and 22 females) with mediastinal cysts have been treated at the Second Department of Surgery at Okayama University from 1978 to 1989. There were thirteen cases of thymic cyst, nine cases of pericardial cyst one case of pericardial diverticulum, eight cases of bronchogenic cyst, two cases of dermoid cyst, two cases of cystic lymphangioma, one case of esophageal cyst, one case of gastroenteric cyst, and one case of aneurysmal bone cyst. MRI seemed to be useful for the qualitative diagnosis of mediastinal tumors as cystic or solid. Based on Maier's classification and considering the result of this study, bronchogenic cysts may be divided into the following groups: 1) paratracheal, 2) carinal, 3) hilar, 4) paraesophageal [a) upper (Iu), b) lower (Im, Ei)], 5) cephalad recess of the azygos vein (CRAzV) and 6) miscellaneous. According to this new classification, these bronchogenic cysts could be allocated to (3) hilar: 1 cyst, (4-a) paraesophageal-upper: 1 cyst, (4-b) paraesophageal-lower: 1 cyst, (5) CRAzV: 4 cysts, and (6) miscellaneous: 2 cysts.
Adolescent↗
[Clinical evaluation of Augpenin (clavulanic acid-ticarcillin) in urinary tract infections: especially against beta-lactamase producing strains].
Augpenin contains ticarcillin (TIPC) and clavulanic acid (CVA), at a ratio of 15:1. The beta-lactamase inhibitor, CVA, has been added to protect the TIPC from inactivation by beta-lactamase. To investigate the drug efficacy and safety against urinary tract infections (UTI), Augpenin was administered to 33 patients with chronic complicated UTI and 7 patients with acute pyelonephritis. Thirty two cases were evaluable by the UTI criteria. Excellent results were obtained in 6 of the cases of acute pyelonephritis, and moderate results in 1 case, with an overall effectiveness rate of 100%. Excellent results were obtained in 14 of the cases of chronic complicated UTI, moderate results in 9 cases, and poor results in 2 cases, with an overall effectiveness rate of 92%. No adverse reactions were noted, but a transient elevation of glutamic oxaloacetic transaminase and glutamic pyruvic transaminase levels was observed in 2 cases.
Adolescent↗
[Adequate parameters for the diagnosis of disseminated intravascular coagulation (DIC) in patients with liver diseases].
Despite of many investigations addressing the problem on the diagnosis of DIC associated with liver diseases, however, an adequate clinical and laboratory criteria has not yet been established. We attempted to clarify this problem by evaluating the changes of plasma levels of PIC, D dimer, TAT and several endothelial factors in 20 patients with severe liver disease who had the evidence of hemorrhage, and were treated with AT III concentrate and gabexate mesilate (FOY). In patients who show a good response to treatment, plasma levels of PIC and D dimer before treatment were both significantly higher (p < 0.01) than those in patients who did not respond, while there was no significant difference in other coagulation fibrinolysis parameters except for platelet count which showed rather lower in the response group (p < 0.05). We believe that combination assay for both PIC and D dimer will be adequate to differentiate whether the hemostatic abnormalities are induced mainly by DIC or hepatic insufficiency.
Adult↗
[A clinical study of resected adenoid cystic carcinoma of the tracheobronchial tree].
From 1973 to 1990, 7 patients presented with a adenoid cystic carcinoma of tracheobronchial tree that was treated surgically. The locations were larger airways; 4 in the trachea, 1 in the carina, 2 in the basal bronchus. Surgical treatments were performed in all cases. The following resections were done: trachea only 3; carina 1; trachea plus larynx 1; left lower lobe (sleeve lobectomy) 1; left lung (pneumonectomy) 1. Except for tracheolaryngectomy and left pneumonectomy, all cases were undergone primary anastomosis. Operative death was only one patient who died of anastomotic separation. Irradiation was performed in 6 patients before or after operation. Two patients were died due to lung metastases or leukemia. According to the Kaplan-Meier's method, the 5 years survival rate of all patients was 68.6%. Our experience suggests that surgical treatment and adjunctive radiotherapy is beneficial in patients with adenoid cystic carcinoma.
Adult↗
[Thoracoscopic treatment of bronchogenic cyst].
A central bronchogenic cyst was excised thoracoscopically from a 44-year-old woman in whom a tumor had been pointed out in the left upper posterior mediastinum at a screening examination. Since the tumor was diagnosed to be benign, only conservative follow-up was undertaken, but the patient consulted our department desiring active therapy. On the basis of the chest CT and MRI findings a bronchogenic cyst was diagnosed. Under general anesthesia and mechanical ventilation of one lung, the thoracoscope was inserted into the thoracic cavity revealing in the left upper posterior mediastinum a cyst which was excised thoracoscopically. While coagulation was performed gingerly with an electric scalpel, the tumor was detached sharply and bluntly with a pair of scissors. The postoperative course was uneventful with little wound pain or scar formation. Hitherto bronchogenic cysts have been treated by resection after thoracotomy. Although this is an easy procedure, a relatively large operative scar is left and considerable wound pain may develop. In contrast, thoracoscopic treatment is characterized by minimal surgical invasiveness, little postoperative wound pain, and small scars. These advantages suggest that this technique may be indicated for benign mediastinal tumors, particularly cysts.
Adult↗
Response of MBT-2 bladder carcinoma-induced osteolysis to various agents.
Tumor-bone interactions were experimentally studied using a bladder tumor in mice (MBT-2). The method consisted of subcutaneously inoculating tumor cells over the calvaria in nude mice after the periosteum was disrupted. This resulted in a local tumor that caused fragmentation of the bone. Bone destruction was found to increase in proportion to the number of osteoclasts in the earlier phase. The osteoclasts decreased in number when the tumors had grown large enough to envelop the residual bone. However, bone destruction continued and seemed to be mediated by the tumor cells by a mechanism that did not involve the osteoclasts. The effects of several agents were investigated in this model. High doses of calcitonin and cyclosporine reduced the bone resorption, and these agents may be effective in the early phase of bone destruction. A bisphosphonate derivative (AHBuBP) inhibited bone resorption markedly in the early and late phases of bone destruction. Autoradiography using carbon 14 (14C)-labeled AHBuBP showed that the isotope was concentrated at the surface of the bone adjacent to the MBT-2 tumors. These results suggest that bisphosphonates may make bone less susceptible to the actions of osteoclasts and tumor cells.
Alendronate↗
Correlation between the prostatic vein and vertebral venous system under various conditions.
In dogs, the venous blood from the prostate gland was observed under X-ray fluoroscopy to drain into the vertebral venous system under conditions of abdominal compression, the addition of various intraabdominal pressures, and occlusion of the inferior vena cava by a balloon catheter. Pressure in the inferior vena cava and abdominal cavity were measured simultaneously. The venous blood draining from the prostate gland started to flow from the inferior vena cava into the vertebral veins at more than 25 mmHg of intraabdominal pressure with the animal in the supine position. The average pressure of the inferior vena cava draining into the vertebral veins was 12.8 +/- 1.3 mmHg in the supine position and 21.1 +/- 2.7 mmHg in the standing position. The average intraabdominal pressures were 35.5 +/- 3.9 mmHg and 30.1 +/- 2.8 mmHg, respectively. Under conditions of abdominal compression and balloon occlusion of the inferior vena cava, the materials flowed into the vertebral venous system from various routes, such as the internal iliac vein, common iliac vein, and inferior vena cava. It was suggested that the inferior vena caval blood easily enters the vertebral venous system in the standing position by adding high intraabdominal pressure, and that the vertebral venous system may be useful for experimental study of drug administration in bone metastasis of prostate cancer.
Animals↗