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Biomedical subjects

K Okamura

Publications and source records attributed to K Okamura.

At least 181 records · Page 10Linked to original sources
PubMed1996

Transfer of latissimus dorsi for irreparable rotator-cuff tears.

We treated 12 shoulders in ten patients with irreparable rotator-cuff tears by transfer of the latissimus dorsi. There were nine men and one woman. Their average age was 64.0 years and the average follow-up was 35.6 months (26 to 42). The results were excellent in four shoulders, good in four, fair in one, and poor in three. Active forward flexion improved from a preoperative average of 99 degrees to a postoperative average of 135 degrees. Osteoarthritic changes appeared in five shoulders and proximal migration of the humeral head progressed in six. EMG revealed that nine of the 12 transferred muscles showed activity which was synergistic with the supraspinatus on external rotation with abduction. We conclude that latissimus dorsi transfer can be effective in restoring shoulder function after massive irreparable tears of the rotator cuff.

Activities of Daily Living↗
PubMed1996

[Intraventricular arachnoid cyst--on the origin of intraventricular arachnoid cysts].

Arachnoid cysts very rarely occur within the ventricular system, where no arachnoid tissue exists. We present three cases of intraventricular arachnoid cyst with special reference to its origin. The first patient was a 5-year-old boy who complained of headaches and enlargement of his head. A CT scan revealed obstructive hydrocephalus and a large cystic lesion in the right lateral ventricle. The symptoms resolved after fenestration of the cyst and cystoperitoneal shunt. The second patient was a 49-year-old woman who complained of headache and numbness in her left upper extremity. A CT scan and MRI revealed a large cyst in the trigone of the right lateral ventricle. Fenestration of the cyst wall and cystoperitoneal shunt were performed relieving her complaints. The third patient was a 42-year-old man who complained of frequent seizures and dizziness. A CT scan and MRI demonstrated a moderate size cystic mass in the inferior horn of the right lateral ventricle. The symptoms were improved by partial resection of the cyst wall. Immunohistochemical studies and light microscopy confirmed that the cyst walls were composed of arachnoid membrane, implying that the cysts were arachnoid cysts. CT and MRI in these three cases showed widening of the choroidal fissure bordering the cyst wall, occasionally involving a part of the protruding cyst wall. On enhanced CT and MRI, the choroid plexus in the trigone of ipsilateral lateral ventricle was displaced anterolaterally, implying that the cysts had grown from outside the choroid plexus. Postoperative MRI demonstrated the shrunken cyst wall attached to the choroidal fissure. The surgical findings in case 3 also showed that the cyst wall was attached firmly to the choroid plexus. These findings appeared to indicate that the intraventricular arachnoid cyst originated from the arachnoid layer drawn into the choroidal fissure with choroidal vascular mesenchyme.

Adult↗
PubMed1995

Familial pericentric inversion incidentally detected at prenatal diagnosis.

A case of familial heterozygous pericentric inversion of chromosome 1 [inv(1)(p13q23)] is presented. The inversion was incidentally detected in a fetus whose mother received prenatal chromosomal diagnosis due to her age (40 years old), and thereafter the same inversion was detected in the father whose phenotype was normal. No abnormalities were found in the phenotype of the newborn carrier. Semen analysis of the father revealed normal findings. The couple had no history of spontaneous abortion.

Adult↗
PubMed1995

An immunohistochemical and ultrastructural study of vasomotor nerves in the microvasculature of human dental pulp.

Immunohistochemical methods for S-100 protein and neurone-specific enolase showed two types of nerve endings around the pulp microvasculature: the free endings, which comprise the major neural component and are distributed in all types of microvessel such as arterioles, venules and capillaries; and the varicose endings. The varicose ending was a less frequent, minor component observed only in the arterioles. Both immunohistochemical and ultrastructural observations confirmed that the varicose endings were the terminal axons of efferent vasomotor nerves. Further extensive ultrastructural examinations on the vasomotor nerves added the following new findings to our previous reports. Vasomotor nerves sometimes ramified into more than two terminal axons around arterioles, and most of these ramified axons ended in the adventitia-media junction of the arteriolar wall; however, nerve endings occasionally penetrated into the media. These findings suggest an intimate structural association between vasomotor nerves and arterioles in regulating the arteriolar microcirculation in human dental pulp by stimulating smooth-muscle cells not only of the outermost but also of the inner layers. Furthermore, the deep penetration of terminal axons into the arteriolar wall seems to provide effective regulation of pulpal blood flow under physiological and pathological conditions.

Adult↗
PubMed1995

Ultrastructural relation between nerve terminals and dentine bridge formation after pulpotomy in human teeth.

Close association between nerve terminals and preodontoblasts, odontoblasts and predentine was observed during healing after pulpotomy. The nerve terminals frequently contained large numbers of synaptic vesicles. Terminals with many vesicles tended to be fewer in the predentine than in the odontoblastic layer. The distribution of terminals was more dense at the stage before the regenerated odontoblasts became arranged regularly beneath the predentine. It is suggested that these terminals have some efferent role(s), especially during collagen synthesis at the early stage of dentinogenesis. The nerves may release their abundant synaptic vesicles, in addition to serving a sensory role for monitoring the increased sensitivity in the injured areas.

Dentin, Secondary↗
PubMed1995

Immunohistochemical study on the immunocompetent cells of the pulp in human non-carious and carious teeth.

The condition of the pulp tissue was classified into seven groups according to the depth of carious lesions from stage (S) 0 (non-carious teeth) to S6 (exposed pulp). A substantial change in the infiltration of immunocompetent cells occurred between S3 and S4; all types were markedly increased in S4 as compared to S3, with a remarkable increase in the number of helper T lymphocytes, B-lineage cells, neutrophils and macrophages. Therefore, the pulpal immune reaction to carious stimuli could be classified into early (S1-S3) and advanced phases (S4-S6). In the early phase a cellular immunoresponse would be induced by T-lineage cells, and in the advanced phase the humoral immunoresponse is furthered by B-lineage cells concomitant with the destruction of pulp tissue by proteolytic enzymes released from infiltrating neutrophils and macrophages. Human dental pulp is thus equipped with a functional immune response that is sufficient as a biodefensive mechanism. Dental caries should be treated before S4.

Adult↗
PubMed1995

Molecular biologic analyses of tetragametic chimerism in a true hermaphrodite with 46,XX/46,XY.

OBJECTIVE: To investigate the mechanism of the formation of a tetragametic chimera with true hermaphroditism (46,XX/46,XY). DESIGN: Molecular biologic analyses. SETTING: Outpatient clinic and laboratories of a university hospital. SUBJECTS: A true hermaphrodite with 46,XX/46,XY and the parents. MAIN OUTCOME ANALYSIS: Restriction fragment length polymorphism (RFLP) of the pseudoautosomal region on sex chromosomes. RESULTS: Whereas a normal diploid individual showed two bands, the true hermaphrodite showed four bands in the RFLP analyses. Evaluation of the molecular weights of the bands revealed two of them to be of maternal origin and the other two to be of paternal origin. CONCLUSION: The two cell lineages composing the true hermaphrodite are heterogeneous because those originated from the fertilization of two genetically different maternal haploid cells by two different spermatozoa.

ABO Blood-Group System↗
PubMed1995

A study by means of a new assay of the relationship between an outbreak of erythema infectiosum and non-immune hydrops fetalis caused by human parvovirus B19.

An enzyme-linked immunosorbent assay (ELISA), used to detect IgG and IgM antibody specific for human parvovirus B19, was established by use of human parvovirus B19 capsid protein VP-1 expressed in Escherichia coli. Paired samples of serum derived from 44 mothers and single samples derived from 24 babies having unexplained non-immune hydrops fetalis (NIHF), were tested by means of the assay. Five cases (11%) of NIHF were suspected of having been induced by intrauterine human parvovirus B19 infection because the samples of maternal serum were positive for parvovirus B19 IgM antibody. Four of the five cases arose during an outbreak of erythema infectiosum. According to our study and previous reports over 90% of NIHF caused by parvovirus B19 intrauterine infection have become clinically overt in the second trimester of pregnancy during a period ranging from 15 to 27 weeks of gestation.

Blotting, Western↗
PubMed1995

Production of complete heart block and utero cardiac pacing in fetal lambs.

We produced a complete heart block in 5 fetal lambs at 120 to 135 days of gestation by injecting 10% formaldehyde into the His bundle. We obtained acute experimental data in 5 fetuses and chronic experimental data in 2 fetuses. Immediately after production of the complete heart block, cardiac output was acutely reduced to 43 +/- 9% when compared with the cardiac output at sinus rhythm. It was possible to restore the cardiac output to 80 +/- 7% of the preoperative levels by atrioventricular pacing at the same rate as had been present before the heart block was produced. When the heart rate decreased below 100 beats per minute, further increase of stroke volume did not occur, and output was markedly diminished. This model allows us to study the pathophysiological response of a complete heart block, and offers basic information useful for understanding fetal cardiac functioning.

Animals↗
PubMed1995

Endoscopic trigonoplasty for primary vesico-ureteric reflux.

OBJECTIVE: To investigate the surgical results of endoscopic trigonoplasty in patients with primary vesicoureteric reflux. PATIENTS AND METHODS: Records were reviewed for 12 patients who underwent endoscopic trigonoplasty between February 1992 and February 1994. Of the 12 patients, 11 were female; one was a child and nine had unilateral disease. From 15 renoureteric units, grade I vesico-ureteric reflux was demonstrated in five, grade II in six and grade III in four. The ureteric orifices were approximated close to the midline via the urethral route and two trocars on the abdomen achieved pneumobladder. RESULTS: The mean surgical time was 178 +/- 52 min; this lessened as the learning curve developed. Intra-operative complications in three patients were all caused by trocar placement. Eleven patients required analgesics for one post-operative day only. No post-operative dilatation of the upper urinary tract was demonstrated. Vesico-ureteric reflux was eradicated in all patients. CONCLUSIONS: Endoscopic trigonoplasty is a minimally invasive procedure with a high cure rate. By not destroying the normal vesico-ureteric junction, post-operative obstruction cannot occur. We believe that endoscopic trigonoplasty is a feasible procedure for patients with vesico-ureteric reflux.

Adolescent↗
PubMed1995

Changes in nerve fibers adjacent to transplanted VX2 carcinoma in rabbit tongue.

This study was undertaken to examine the relationship between malignant tumor tissue and nerve fibers using a transplantation model and nerve fiber strains. Most of the neural tissue, as well as the other host tissues, showed severe degenerative changes as the transplanted tumor grew. Furthermore, the degenerative changes were chiefly confined to the area anterior to the tumor. These changes were probably provoked chiefly by the compressive effects of the rapidly enlarging transplant. The results could possibly explain clinical symptoms such as paralysis or disturbances in the movement of the tongue observed occasionally in some patients with lingual carcinomas.

Animals↗
PubMed1995

Human T-lymphotropic virus type I-associated uveitis in patients with Graves' disease treated with methylmercaptoimidazole.

Human T-lymphotropic virus type I (HTLV-I) is responsible for a certain form of uveitis [HTLV-I-associated uveitis (HAU)]. A previous history of Graves' disease has been reported in 9-17% of the patients with HAU. In this study, the prevalence of patients with either HTLV-I antibody or uveitis was evaluated in 819 consecutive patients with thyroid disorders between 1991 and 1992. Serum HTLV-I antibody was found in 25 of 392 patients with Graves' disease, 19 of 257 with chronic thyroiditis, and 3 of 170 with nodular goiter. Five of 25 HTLV-I-positive patients with Graves' disease developed HAU. All of these 5 patients had been treated with methylmercaptoimidazole (MMI). Within a few months before the onset of uveitis, 3 patients were hyperthyroid, and 2 were hypothyroid. In 2 of 5 patients, an exacerbation of uveitis occurred soon after the readministration of MMI for the relapse of hyperthyroidism. None of the 367 HTLV-I negative patients with Graves' disease nor 22 HTLV-I-positive patients with chronic thyroiditis or nodular goiter developed uveitis. It was therefore suggested that Graves' disease, thyroid dysfunction and/or MMI administration might be related to the development of HAU.

Adult↗
PubMed1995

Nucleotide sequence analysis of the carbomycin biosynthetic genes including the 3-O-acyltransferase gene from Streptomyces thermotolerans.

A 3.2-kb DNA fragment of the carbomycin biosynthetic region including the 3-O-acyltransferase gene (acyA) from Streptomyces thermotolerans was sequenced, and four ORFs were found in the fragment. The second ORF, designated ORF-A, was transcribed in the opposite direction to the other three ORFs. The first ORF was identified as carA, a gene for carbomycin resistance. The amino acid sequence of ORF-A was homologous to proteins of the cytochrome P-450 family. Streptomyces lividans transformed with pCB20, in which ORF-A was subcloned, epoxidized carbomycin B at its C-12, 13 positions, thus producing carbomycin A. The third ORF, the amino acid sequence of which showed a homology to macrolide antibiotics O-acyltransferases was identified as acyA. The last ORF (ORF-B), which starts just 3 bp downstream from the TGA termination codon of acyA, was thought to be a carbomycin 4-O-methyltransferase gene, because the amino acid sequence deduced from ORF-B showed high homology to a putative midecamycin 4-O-methyltransferase encoded on mdmC.

Acetyltransferases↗
PubMed1995

Acute spontaneous hemorrhagic degeneration of the thyroid nodule with subacute thyroiditis-like symptoms and laboratory findings.

Seventeen consecutive patients (3 men and 14 women, aged 14-75 years) with a hemorrhagic degeneration of the thyroid nodule, which was confirmed by both ultrasonography and either reddish or brown fluid evacuated by fine-needle aspiration, were classified as either acute type with an episode of abrupt painful swelling of the thyroid (n = 4), or chronic type in which a painless thyroid nodule was incidentally found (n = 13). One of the four acute type patients demonstrated subacute thyroiditis-like symptoms and laboratory findings including transient painful thyrotoxicosis associated with high serum levels of thyroid hormones and thyroglobulin (Tg), a suppressed serum TSH level, a low thyroidal radioactive iodine uptake (RAIU), and accelerated erythrocyte sedimentation rate (ESR). In the other three acute type patients the serum level of Tg increased markedly, the serum thyroid hormones level increased in one, the thyroidal RAIU was low in two, and the ESR was accelerated in one. In the thirteen chronic type patients, the serum levels of the thyroid hormones and the thyroidal RAIU were within the normal range, and few inflammatory signs were observed. These findings suggest that acute hemorrhagic degeneration of the thyroid nodule may thus cause transient subacute thyroiditis-like symptoms and laboratory findings.

Acute Disease↗
PubMed1995

Effects of fructose ingestion on carbohydrate and lipid metabolism during prolonged exercise in distance runners.

The effects of ingestion of fructose (F), as well as of arginine (A) and citric acid (C) on both carbohydrate metabolism and lipid metabolism during prolonged exercise in seven distance runners on treadmill running were investigated by comparing it with those of glucose + arginine + citric acid (GAC) and placebo. With the values of the plasma glucose, though FAC as well as placebo contrastively indicated almost a flat distribution, GAC increased from 30 min rest before the exercise (i.e., the time for 500 ml intake of GAC) to the beginning of the exercise. The plasma glucose for GAC showed significantly higher values (138 +/- 22 mg/dl) than that for FAC or placebo, whose values were 102 +/- 18 mg/dl and 93 +/- 8 mg/dl, respectively. The plasma glucose for GAC was likely to decrease gradually as the exercise progressed more. At the end of exercise, however, the plasma glucose for FAC indicated significantly higher values (100 +/- 12 mg/dl) than that for GAC, whose values were 89 +/- 12 mg/dl. Though the serum free fatty acid showed upward tendencies of values in all cases of FAC, placebo, and GAC as the exercise progressed, no significant difference of the values in those cases was observed (the following values were drawn at the end of the exercise; FAC:655 +/- 185 microEq/l, placebo:603 +/- 289 microEq/l, GAC:485 +/- 140 microEq/l).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

Acute revascularization for bihemispheric anterior cerebral artery thrombosis--case report.

A 65-year-old male presented with rapidly progressive paraparesis and akinetic mutism due to occlusion of the bihemispheric anterior cerebral artery (ACA). He was treated by intra-arterial thrombolytic therapy but reocclusion of the arteriosclerotic lesion occurred. Bilateral superficial temporal artery (STA)-ACA anastomoses achieved lasting neurological improvement. Bilateral STA-ACA anastomoses are quite effective to prevent ischemia of the bilateral ACA territories.

Aged↗