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Biomedical subjects

K Okada

Publications and source records attributed to K Okada.

At least 973 records · Page 54Linked to original sources
PubMed1992

[Adjuvant chemotherapy for invasive bladder cancer. Multicenter study].

During 2 years and 10 months from November 1985 to September 1988, 50 patients with invasive bladder cancer (pT2-4, pN0-2, M0) were treated with total cystectomy followed by adjuvant combination chemotherapy including cis-platinum. In addition, so-called immunopotentiator (OK-432) and Kanpo (Juzentaihoto: TJ-48) were given to the patients in a random fashion to evaluate whether or not these agents had any significant effect on patients' prognosis. The 3- and 5-year survival rates for 48 evaluable patients were 71% and 67%, respectively. Histologic grade of primary tumors and number of cycles of adjuvant chemotherapy administered had a significant correlation to patients' survival: patients with grade 2 anaplasia had a better 3- and 5-year survival rates than those with grade 3 anaplasia, and patients receiving 3 or more cycles of chemotherapy had a better 3-year survival rate than those with 2 or less cycles. pT and pN categories also affected patients' survival, though not statistically significant. Administration of OK-432 or TJ-48 and pre-operative treatment such as irradiation and intra-arterial chemotherapy had no favourable effects on the survival. Side effects of the adjuvant chemotherapy were minimal to moderate and more than 70% of the patients tolerated at least 3 cycles of chemotherapy. It is likely that adjuvant chemotherapy, when given in a post-operative setting, should be repeated at least 3 cycles or more.

Adult↗
PubMed1992

[Esophago-bronchial fistula caused by chemotherapy with bronchial artery infusion for pulmonary metastases from urinary tract cancer].

We treated a patient who had had postchemotherapeutic pulmonary metastases from urinary tract cancer by bronchial artery infusion (BAI) chemotherapy. Pulmonary lesions showed a 33.0% reduction after the treatment. However, esophago-bronchial fistula (EBF) occurred after the second BAI. The patient died of recurrent aspiration pneumonia and sepsis in the sequelae of the repair surgery. The fistula was considered to have resulted from an increase in the blood flow to the esophageal branch originating from the bronchial artery after the first BAI, which had consequently damaged the local tissue due to accumulation of anti-cancer drugs. In order to avoid these complications, the secondary change of blood flow should be examined precisely by preceding angiographical mapping, and the concentration and the infusion speed of the cytotoxic drugs, should be under adequate control.

Adult↗
PubMed1992

Clinical features of patients suffering from Streptococcus milleri infections--a retrospective analysis.

We examined the clinical records of patients from whom S. milleri was isolated at Kyushu University Hospital from January 1987 through December 1988. Sixty-one patients were treated in 64 episodes with drainage or antibiotics. Oral and nasopharyngeal infections were observed in 27 cases, intrathoracic infections in 13, urogenital infections in 8, intraabdominal infections in 6 and skin and subcutaneous infections in 6. Except for acute bronchitis and urogenital infections, all of them were suppurative. As to underlying diseases, 21 patients had malignancies and 6 had diabetes mellitus. Leukocytopenia was not observed in any of the patients. S. milleri can be eradicated by treatment but it is sometimes replaced by other organisms. However, considering its tendency to cause suppurative infections, its pathogenic significance should be taken into account and patients should undergo surgical drainage combined with antibiotic therapy.

Humans↗
PubMed1992

[Prophylactic chemotherapy by regional arterial infusion in resected hepatoma patients].

We established risk factors for high post-resectional recurrence in patients with hepatocellular carcinoma (HCC). They included: (1)Vp (+), (2)IM (+), (3)more than 5 cm in diameter of the main tumor, and (4)gross type except single nodular tumor. Seventy HCC patients in this category were divided into two groups. In group 1, 11 patients prophylactically underwent hepatic arterial infusion chemotherapy after liver resection. Chemotherapeutic agents (MMC, 5-FU, ADM, CDDP) with Lipiodol were administered 4 times a year via Infuse-A-port. The remaining 59 cases served as the control without prophylactic infusion. Two-year survival rate was better in prophylactic group (75%) than in the control (46%, p = 0.063). The two-year disease-free survival was significantly improved in group 1 (40%) compared with that in group 2 (26%, p = 0.019). Based on our data, we suggest that prophylactic arterial infusion chemotherapy can be efficacious in alleviating hepatoma recurrence after liver resection.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1992

Characterization of human tissue-type plasminogen activator variants with amino acid mutations in the kringle 1 domain.

Recombinant variants of tissue-type plasminogen activator (t-PA) were constructed by site-directed mutagenesis and expressed in Chinese hamster ovary cells. Five variants were designed to improve the function of t-PA by mutagenesis in the kringle 1 (K1) domain. The amino acids were replaced with the corresponding residues present in the kringle 2 (K2) domain of native t-PA. The t-PA mutants expressed were as follows: variant E94V.D95G with point mutations in Glu94----Val and Asp95----Gly; variant N115P.S119M, Asn115----Pro and Ser119----Met; variant P125A.R129Q.R13OS, Pro125----Ala, Arg129----Gln and Arg130----Ser; variant G161R.K162R.-S165W, Gly161----Arg, Lys162----Arg and Ser165----Trp; and variant N115P, Asn115----Pro, respectively. The half-life following intravenous bolus injection in rabbits was prolonged in all variants except P125A.R130S. This was particularly true for N115P.S119M. The kinetic parameters for plasminogen activation were improved in t-PA G161R.K162R.S165W which showed a 0.6-fold decrease in Km, and a 1.8-fold increase in Vmax, thus promoting a 2.7-fold increase in kcat/Km compared to native t-PA. For a similar degree of thrombolysis in the rabbit jugular vein thrombosis model, the thrombolytic activity of G161R.K162R.S165W, at the dose tested, was four-fold greater than that of native t-PA. Thus, the substitution of the amino acids in the K1 domain with those corresponding in the K2 domain significantly enhanced the enzymatic activity of t-PA and improved the plasma survival.

Amino Acid Sequence↗
PubMed1992

Modulation by intracellular calcium pool of arginine vasopressin-induced cellular cyclic AMP production in rat renal papillary collecting tubule cells in culture.

The present study was undertaken to determine whether endoplasmic reticulum is involved in the cellular action of arginine vasopressin (AVP) in rat renal papillary collecting tubule cells in culture, using three dissimilar agents. 1 x 10(-7) M AVP increased cytosolic free Ca++ concentration ([Ca++]i) from 93.2 to 188.6 nM (P < .01). Exposure to 1 x 10(-4) M 3, 4, 5-trimethoxybenzoic acid, 8-(diethylamino) octylester hydrochloride (TMB-8), which inhibits intracellular Ca++ mobilization and blocks the function of endoplasmic reticulum, attenuated the [Ca++]i response to AVP. A significant increase in [Ca++]i in response to 1 x 10(-7) M AVP was obtained with Ca(++)-free medium containing 1 x 10(-4) M ethylene glycol bis(beta-aminoethyl ether)N,N'-tetraacetic acid (EGTA) (52.3 to 98.3 nM). However, when cells were preincubated with Ca(++)-free medium containing a mixture of 1 x 10(-4) M EGTA and 1 x 10(-4) M TMB-8, the 1 x 10(-7) M AVP-mobilized [Ca++]i was completely abolished. In the presence of 5 x 10(-4) M 3-isobutyl-1-methylxanthine, AVP increased cellular cyclic AMP (cAMP) production in a dose-dependent manner. Such an AVP-induced cAMP production was significantly reduced in cells exposed to Ca(++)-free medium containing 1 x 10(-4) M EGTA. After exposure to Ca(++)-free medium containing a mixture of 1 x 10(-4) M EGTA and 1 x 10(-4) M TMB-8, the cAMP response to AVP was markedly reduced.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1992

P300 event-related potentials correlated with cerebral blood flow in nondemented patients with lacunar infarction.

We have studied the relationship between the P300 latency and regional cerebral blood flow (rCBF) in 25 nondemented patients who had lacunar infarctions in the territory of the deep perforating branches of the internal carotid artery system. A significant prolongation of the P300 latency with advancing age was observed. There was a negative correlation between the P300 latency and the rCBF. These results indicate that a combination of P300 latency and rCBF measurements might prove more sensitive in detecting mental decline than rCBF studies alone in nondemented patients with lacunar infarctions.

Adult↗
PubMed1992

[Field trial for the early detection of patients with ovarian cancer--discrimination of ovarian cancer patients by the statistical analysis using Mahalanobis' generalized distance].

Six tumor-associated antigens, cancer antigen 125 (CA125), tissue polypeptide antigen (TPA), ferritin (Fr), carcinoembryonic antigen (CEA), alpha fetoprotein (AFP), and sialyl Lex-i (SLX) were measured simultaneously for the early detection of ovarian cancer. To decrease the number of both false positive and false negative cases in the combination assay, statistical discrimination analysis employing the serum values for appropriate tumor markers has been studied with respect to ovarian cancer by the method of Mahalanobis' generalized distance. The new "ovarian cancer screening test" designed by us has been used in Shizuoka Prefecture since 1988, and 23,307 serum samples have been analyzed. One hundred twenty-seven of 165 ovarian cancer patients were suspected as having cancer by such clinical procedures as pelvic examination and/or ultrasonography, while in 150 patients cancer was detected by the statistical discrimination method. Thirty-one of 38 patients with ovarian cancer overlooked by the clinical procedures could be found by the statistical method. We conclude that clinical procedures and the statistical method can be complementary in detecting patients with this malignancy.

Adult↗
PubMed1992

[Efficacy of nicorandil on myocardial protection during coronary artery bypass grafting--a comparison with diltiazem].

Diltiazem (DTZ), a calcium slow channel blocker, is estimated to be highly effective for myocardial protection and the prevention of perioperative coronary spasms (PCS). However, the use of high doses of DTZ sometimes results in difficulty in coming off cardiopulmonary bypass due to negative chronotropic activity. Nicorandil (NCD) has remarkable coronary vasodilating effect but possesses little negative chronotropic activity. The purpose of this study was to compare NCD with DTZ with respect to effect on myocardial protection during coronary artery bypass grafting (CABG). As parameters, excess lactate (delta XL), redox potential (delta Eh), left and right ventricular stroke work indices (LVSWI, RVSWI), cardiac index (C.I.), systemic vascular resistance index (SVRI.), myocardial isoenzymes (CK-MB, LDH1), number of PCS and recovery time of chronotropic action were used. delta XL, delta Eh, LVSWI, RVSWI, C.I., SVRI, CK-MB, LDH1 were measured at 0, 1, 3, 6, 9, 18 and 24 hours after the removal of aortic cross clamping. The degree of chronotropic action was evaluated by the length of the recovery time to self beat or normal sinus rhythm after the removal of aortic cross clamping. Forty patients who underwent CABG with retrograde cold blood cardioplegia between Dec. 1989 and May 1991 were divided into the NCD group (n = 20), in which 1.1 micrograms/kg/min NCD was continuously administered from the beginning of the operation and the DTZ group (n = 20), in which the initial St. Thomas cardioplegia containing 5 mg/L and subsequent cold blood cardioplegia solution contained DTZ 3.5 mg/L, for a total DTZ dose of less than 10 mg.(ABSTRACT TRUNCATED AT 250 WORDS)

Cardioplegic Solutions↗
PubMed1992

[Coronary artery bypass surgery in patients with severely impaired left ventricular function].

The efficacy and problem of coronary artery bypass grafting (CABG) in patients with severely impaired left ventricular function (left ventricular ejection fraction < or = 30%) were assessed in 27 patients of whom 17 (group 1) underwent emergent CABG and 10 (group 2) elective between Jan 1984 to Aug 1990. As a whole, history of myocardial infarction (24/27, 88.9%), large left ventricular volume with reduced ejection fraction (LVEDVI 126.08 +/- 25.91 ml/m2, LVESVI 93.04 +/- 21.02 ml/m2, LVEF 25.04 +/- 4.75%) and multiple vessel disease with at least one vessel total occlusion (20/27, 74.1%) were characteristically seen in these patients. The patients of group 1 were significantly older (mean 66.12 +/- 5.68 vs 57.10 +/- 8.08, p < 0.01) and needed more frequent preoperative support with IABP (17/17 vs 4/10, p < 0.01). Using Thallium-201 scintigraphy, in 10 patients of group 1 and 9 of group 2, myocardial viability in the proposed bypass area was evaluated before operations. Average 2.37 +/- 0.79 grafts were placed and continuous retrograde cold blood cardioplegia via the coronary sinus was employed for myocardial protection. Two mitral annuloplasty (MAP) for ischemic mitral regurgitation and 2 cryoablation for the treatment of ventricular tachycardia were performed concomitantly. Operative mortality was 47.1% in group 1 and none in group 2 (p < 0.05). Two cases of MAP died, but two cases of cryoablation survived. Postoperative LVEF was improved significantly only in group 2 (p < 0.05), but during the follow-up period of 7 months to 6 years, all 19 survivors expect one remains with NYHA class I or II.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Effects of nicorandil on regional cerebral blood flow in patients with chronic cerebral infarction. Preliminary communication.

The effect of a single oral dose of nicorandil (N-2-(hydroxyethyl)-nicotinamide nitrate, CAS 65141-46-0) on the regional cerebral blood flow (rCBF) was studied in 9 patients with cerebral infarction. The rCBF was measured by the Xe-133 inhalation method before and after a single oral 10 mg dose of nicorandil. Mean arterial blood pressure (MABP) was mildly but significantly decreased. PeCO2 did not change significantly. Mean rCBF was significantly increased by 20.9% after administration of nicorandil (p less than 0.05). No significant correlation between percentage change in the MABP and percentage change in the rCBF was observed. These results indicate that nicorandil is not just a coronary vasodilator, but also possesses beneficial effects on the cerebral circulation in patients with cerebral infarction.

Aged↗
PubMed1992

Cross-reactivity between a monoclonal antibody that recognizes a tumor-associated antigen on bovine lymphosarcoma cells and blood lymphocytes from various mammalian species.

Tumor-associated antigens that are expressed in lymphosarcoma B cells of cattle with enzootic bovine leukosis had been analyzed in terms of their reactivity with 13 monoclonal antibodies (MAB). By use of flow cytometry and radioimmunoprecipitation, 1 of the MAB (c143) that recognized a tumor-associated antigen cross-reacted with blood lymphocytes (BL) from various mammalian species. By use of flow cytometry, the c143 MAB reacted with 10 to 49% of BL derived from human beings, mice, dogs, horses, pigs, llamas, sheep, goats, and cattle. Titer of the c143 MAB with BL from horses, pigs, human beings, and llamas ranged between 1:6.0 x 10(4) and 1:5.3 x 10(5); titer associated with BL of goats and sheep was 1:1.6 x 10(6); and that associated with BL of cattle was 1:4.3 x 10(7). The c143 MAB specifically immunoprecipitated 3 homologous proteins from cell extracts of caprine, ovine, and bovine BL (32-, 34-, and 36- to 37-kDa bovine proteins; 31-, 32-, and 36- to 37-kDa caprine proteins; and 31.5-, 33-, and 36- to 37-kDa ovine proteins), but none was immunoprecipitated from human, murine, canine, porcine, and llama BL. These results indicate that the avidity of the c143 MAB in binding to BL from ruminants (eg, goats, sheep, and cattle) is higher than that to BL from human beings, mice, dogs, horses, pigs, and llamas. In sheep, the c143 MAB could immunoprecipitate the aforementioned proteins from BL of the Suffolk breed, but not BL from the Corriedale breed, whereas the c143 MAB immunoprecipitated apparently identical proteins from BL of 4 breeds of cattle.

Animals↗
PubMed1992

[Serial MRI findings in neuro-Behçet disease].

Behçet disease is a systemic disorder characterised by the triad of recurrent aphthous ulcers of the mouth, genital ulcers and uveitis. Neurological involvement is estimated at 10-25% in Behçet disease (neuro-Behçet). These include diplopia, pseudobulbar palsy, cranial nerve palsies, cerebeller ataxia, and cerebral and spinal sensory and motor disturbances. A case of neuro-Behçet disease is reported. A 51-year-old man was admitted with TIA attack. He had been suffering from recurrent oral and genital ulcers for several months before admission. Neurological examination on admission revealed poor mental activity, left facial nerve palsy and left hemiparesis. Lumbar puncture showed CSF pleocytosis. CT and MRI revealed multiple lesions in the cerebral hemisphere and the brain stem. CT showed spotty high density areas with perifocal low density areas in the frontal, temporal and parietal lobe which were enhanced with contrast materials. T1 weighted image of MRI revealed iso intensity areas with perifocal low intensity areas which were enhanced with Gd-DTPA in the frontal, temporal and parietal lobes. T2 weighted image revealed low intensity areas with perifocal high intensity areas in the same regions shown in the T1 weighted image. Moreover ring-like enhanced lesions with Gd-DTPA were revealed in the brain stem and corona radiata in the T1 weighted image. After high dose steroid treatment, he showed marked clinical improvement. CSF pleocytosis was normalized and the lesions were gradually reduced in size and were no longer enhanced with Gd-DTPA. MRI findings are well correlated with clinical features.(ABSTRACT TRUNCATED AT 250 WORDS)

Behcet Syndrome↗
PubMed1992

[Pheochromocytoma discovered in a pregnant woman: a case report].

A case of pheochromocytoma discovered at pregnancy is reported. The patient was a 27-year-old woman who had no symptoms before pregnancy. A sudden hypertensive attack occurred during vaginal examination at the 36th week of pregnancy. Magnetic resonance imaging (MRI) and ultrasonography showed a right adrenal mass. The level of catecholamine in blood and urine was beyond the normal limit. This patient was diagnosed as pheochromocytoma with pregnancy. Cesarean section was immediately done to avoid hypertensive crisis caused by spontaneous delivery. Blood pressure and blood volume were controlled by an alpha-blocker for one month after delivery, and, then the tumor was removed surgically. Pheochromocytoma with pregnancy is life-threatening for the mother and the fetus because of difficult diagnosis and complex clinical features. Early diagnosis and appropriate treatment are mandatory. Pathophysiological characteristics and the treatment of such specified statics are mainly discussed through our successful achievement.

Adrenal Gland Neoplasms↗
PubMed1992

[Coronary artery bypass grafting in patients with poor left ventricular function using retrograde continuous cold blood cardioplegia].

Patients with poor left ventricular function or those requiring urgent surgery may have more extensive ischemic myocardial injury if myocardial preservation is incomplete. We have performed coronary artery bypass grafting (CABG) aimed at complete revascularization in such cases using RC-CBCP, which is considered more effective on myocardial preservation during aortic cross-clamping in particular to protect ischemic area distal to severe coronary artery stenosis or obstruction. In the present study, in 25 patients with poor left ventricular function (left ventricular ejection fraction; LVEF less than or equal to 0.3) including 10 patients who required urgent surgery, the operative results were evaluated. All the distal and proximal anastomoses of grafts (average 2.5 grafts) were completed during one aortic cross-clamping using RC-CBCP, therefore graft flow was obtained immediately after release of the aortic clamping. Though this method required 142 minutes of a mean aortic cross-clamping time, myocardial protection was considered to be preferable judging from postoperative isoenzymatic evaluation and improved ventricular function. Fifteen patients with elective CABG were all alive and restored to NYHA class I to II. Among 10 patients requiring urgent CABG, 4 patients with acute myocardial infarction died but others were restored to NYHA class I to II. We conclude that it is important to aim at complete coronary revascularization in patients with poor left ventricular function and RC-CBCP achieves more effective myocardial protection during CABG in the patients.

Adult↗
PubMed1992

A case of endogenous Enterococcus faecalis endophthalmitis.

A case of successful treatment by vitrectomy and lensectomy of early-stage endogenous endophthalmitis caused by Enterococcus faecalis was reported. The case was a 50-year-old man with poorly controlled diabetes. Following T-tube drainage for a necrotic cholecystitis operation, he developed iridocyclitis in both eyes as well as fever. At the time of his first visit to our clinic, his right eye had already lost light perception. His left eye had visual acuity recognizing hand movement, marked uveitis, complicated cataract, and dense vitreous opacity. As gram-positive cocci were isolated from the aspirated vitreous, lensectomy and vitrectomy under irrigation with antibiotics were conducted. After the administration of systemic postoperative antibiotics and human immunoglobulin, the patient showed remarkable improvement in the state of his ocular fundus. By 60 days after the surgery, the visual acuity of his left eye recovered to 0.2. Endogenous Enterococcus faecalis endophthalmitis has rarely been reported in Japan. The diagnosis and treatment of this disease with reference to the above findings were discussed.

Cataract Extraction↗
PubMed1992

[Chromosomal survey of 1001 subfertile males: incidence and clinical features of males with chromosomal anomalies].

A chromosomal survey using the G-banding technique was performed on 1,001 subfertile males examined at Kyoto University Hospital between January, 1985 and April, 1991. Thirty-six of them had major chromosome anomalies (3.6%). The incidence of major anomalies for the 154 azoospermia patients, 326 oligozoospermia patients with a sperm density of less than 20 x 10(6)/ml, and 521 patients with normal sperm density was 10.4, 4.6, and 1.0%, respectively. The major anomalies found in azoospermic patients were associated with the sex chromosome, whereas autosomal anomalies were found in patients with oligozoospermia. The incidence of anomalies for patients with azoo- or oligozoospermia was significantly higher than that for patients with normal sperm density (p = 0.000003). All of the 12 patients with Klinefelter syndrome were azoospermic. However, the serum testosterone levels were within normal range in 10 of these patients. Testicular biopsies showed spermatogenic arrest in 5 of the 12 azoo- or oligozoospermic patients with structural chromosomal anomalies. Except for one patient, treatments such as varicocelectomy or medication were not effective in the patients with structural chromosomal anomalies. Chromosome studies are important in the evaluation of subfertile male patients with sperm densities less than 20 x 10(6)/ml. Disorders of the spermatogenic process may be directly related structural chromosomal anomalies in some of the patients.

Adult↗