Search PubMed⌕ Search

Biomedical subjects

K Okamura

Publications and source records attributed to K Okamura.

At least 379 records · Page 21Linked to original sources
PubMed1989

[The importance of aortic compliance as a prognostic factor after aortic valve replacement].

A variety of clinical variables and physiological parameters have been discussed in relation to postoperative survival and symptoms in aortic regurgitation (AR). Many of them have been derived from left ventricular morphology and functions, but there has been no parameter from aortic functions. As the heart is united with the aortic tree to form a circulatory system and both heart and aorta affect each other, aortic functions also have an important prognostic value after aortic valve replacement (AVR). This study was performed to clarify the participation of aortic functions in determining the prognosis after AVR. Fifteen consecutive patients undergoing isolated AVR for AR were evaluated. Twenty-one preoperative hemodynamic and dimensional variables of both heart and aorta were analyzed to determine the risk factors for early postoperative morbidity. These variables were obtained from chest X-ray film, electrocardiogram, echocardiogram, cine-aorto-ventriculogram and pressure manometries. All patients were divided in two groups according to the postoperative course. Group I composed of 10 patients took relatively smooth postoperative course, except two patients suffering from cardiac tamponade. Group II composed of 5 patients suffered from low cardiac output syndrome (LOS) and/or dangerous arrhythmias postoperatively. Two out of them died of uncontrollable ventricular arrhythmias. There were no statistic differences between two groups in the factors derived from preoperative examinations, i.e. CTR, LVDsI, PWT, R/Th, %FS, EDVI, EF, CI, LVEDP, etc. Mean aortic compliance of group II, (3.8 +/- 2.1) X 10(-4) mmHg-1, was, however, significantly lower than that of group I, (21.7 +/- 4.8) X 10(-4) mmHg-1, (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

[Treatment of urinary tract infection with cefixime].

Cefixime (CFIX) was administered orally in the treatment of 59 cases of urinary tract infection (UTI). According to the response criteria defined by the Japanese UTI committee, the rate of clinical efficacy for 26 cases of uncomplicated cystitis was 96.2%. The rate of clinical effectiveness of five patients with complicated UTI and five with uncomplicated pyelonephritis was 80.0%. In the other 23 cases which did not meet the response criteria, the efficacy rate was also high. The results indicated that CFIX was an effective drug for the treatment of UTI.

Anti-Infective Agents, Urinary↗
PubMed1989

[Diffusion of sulbactam and cefoperazone into the prostatic tissue].

Diffusion of sulperazone (SBT) and cefoperazone (CPZ) into the prostatic tissue was studied in 20 cases. Two g of SBT/CPZ was injected intravenously and 1 hour later, prostatic tissue was obtained surgically and venous blood was drawn simultaneously. The serum concentration of CPZ (58.0 micrograms/ml +9.2) was higher than that of SBT (25.9 micrograms/ml +/- 9.3) and the prostatic tissue concentration of CPZ (14.9 micrograms/ml +/- 6.1) was higher than that of SBT (10.9 micrograms +/- 6.1). However, the SBT concentration ratio of prostatic tissue to serum level (P/S ratio) was significantly higher (42.5%) than that of CPZ (25.9%). The SBT concentration in the prostatic tissue was high enough to enhance the antibacterial activity of CPZ. SBT/CPZ was appraised to be an effective chemotherapeutic agent for infections of prostate caused by susceptible organisms, especially by beta-lactamase producing bacteria.

Aged↗
PubMed1989

[An analysis of 30 patients with renal trauma: diagnostic value of radiographic examinations].

To evaluate the diagnostic value of radiographic examinations in renal trauma, 30 patients treated between April, 1985 and March, 1988 were examined. The 25 male and 5 female patients ranged in age from 10 to 74 years, with 17 (57%) less than 30 years of age. Causes of injuries were traffic accidents in 19 patients (63%), falls in 5 (17%), sports in 2 (7%), and others in 4 (13%). Twenty-nine patients (97%) had hematuria and 3 (10%) had shock due to renal injury. The presence of shock indicated severe renal injury, but the degree of hematuria did not correlate to severity of injury. Of the 30 patients, 18 (60%) had renal contusions, 7 (23%) had minor lacerations, 4 (13%) had major lacerations and one had vascular injury. One patient had penetrating trauma and the other 29 had blunt trauma. Two patients (7%) had pre-existing renal anomalies. Associated injuries were present in 16 patients (53%). The presence of associated injuries had no relation to the severity of the renal injury. Computerized tomography (CT) with contrast medium was more sensitive to abnormal findings, especially subcapsular and perirenal hematoma, than excretory pyelography. Findings of renal angiography provided additional anatomical information for deciding immediate surgical treatment and for selecting operative methods for salvage of the kidney.(ABSTRACT TRUNCATED AT 250 WORDS)

Accidents↗
PubMed1989

Potentiation of vincristine and actinomycin D by a new synthetic imidazole anti-tumor agent YM534 active against human cancer cells and multidrug-resistant cells.

Ethyl 6-p-5-(l-imidazolyl) pentyloxyphenoxy-2, 2-dimethylhexanoate hydrochloride (YM534) is a new synthetic anti-tumor compound. Combinations of YM534 with other anti-cancer agents were examined to ascertain whether YM534 potentiated other anti-cancer agents against the KB cell line and its multidrug-resistant counterpart, VJ-300. YM534 potentiated the cytotoxic action of vincristine and actinomycin D about 2-fold against KB cells, but not those of daunomycin and adriamycin. By contrast, YM534 only slightly reversed drug-resistance to adriamycin and daunomycin in VJ-300 while it reversed 5-fold vincristine resistance and 60-fold actinomycin D resistance in VJ-300. The reversal effect of YM534 on actinomycin D and vincristine-resistance in VJ-300 cells appeared to be due to enhanced accumulation of [3H] actinomycin D and [3H] vincristine in VJ-300 cells by YM534. YM534 inhibited efflux of actinomycin D and vincristine from VJ-300 cells, and it also enhanced cellular uptake of these anti-cancer agents. YM534 enhanced cellular accumulation of both actinomycin D and vincristine in the sensitive KB cells. YM534 is thus a unique anti-cancer agent since combinations of other anti-cancer agents with YM534 are expected to augment anti-tumor activity of them. By contrast, YM212, a carboxy analog of YM534, had much less activity to potentiate vincristine and actinomycin D). YM534 at 100-1000 microM almost completely inhibited the photoaffinity labeling of [3H] azidopine to the 170-kD P-glycoprotein of VJ-300 cell membranes, but YM212 showed much less inhibitory action on the photoaffinity labeling. YM534 could also inhibit the photoaffinity labeling of deglycosylated P-glycoprotein.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1989

[Idiopathic retroperitoneal fibrosis: report of 4 cases].

We report 4 cases of idiopathic retroperitoneal fibrosis (IRF). Two cases were demonstrated by surgical biopsy, and in one of them ureterolysis was performed at the same time. After pathological diagnosis, these two patients were treated by steroid therapy. The other two patients were suspected to have acute renal failure due to IRF, and they were treated by nephrostomy or by double-J ureteral stent. In one of them retroperitoneal fibrous tissue had almost disappeared on CT examination. None of these 4 patients have had recurrence of IRF.

Acute Kidney Injury↗
PubMed1988

Sigma region located between C mu and C delta genes of human immunoglobulin heavy chain: possible involvement of tRNA-like structure in RNA splicing.

Noncoding regions within the cluster of immunoglobulin heavy chain constant genes in the human genome contained a number of repeats. In the mu-delta intron, two repeating units were contained. One 442-base-long fragment located JH-mu intron (defined as "sigma mu(sigma mu)") occupied the position in the mu-delta intron. The other 1166-base-long fragment located somewhere in front of S (class switch) region of C gamma gene was also found in the mu-delta intron. We defined the repeats in the mu-delta intron as "SIGMA (sigma)". The polarities of the longer repeats in the genome were opposite between the mu-delta intron and the upstreams of C gamma genes. These inverted copies (defined as sigma gamma 3 and sigma gamma 4), located 6 kb upstream of their respective C gamma's, were apparently transcribed in vitro, via RNA polymerase III and transcripts should have contained tRNA-like structures. Small DNA fragments capable of encoding tRNA-like structures were also found in corresponding regions of mouse Ig C gamma cluster.

Animals↗
PubMed1988

Iodide-induced thyrotoxicosis in a thyroidectomized patient with metastatic thyroid carcinoma.

An unusual case of iodide-induced thyrotoxicosis is documented in this article. The patient was a 64-year-old euthyroid man with acromegaly. He also had multiple follicular and papillary thyroid carcinomas with a metastatic lesion in the lumbar vertebrae. After a total thyroidectomy, he became slightly hypothyroid, and the lumbar lesion began to incorporate 131I by scintigraphy. When an iodine-containing contrast medium happened to be injected, a transient increase of serum thyroid hormone level was observed. After complete thyroid ablation with 83 mCi of 131I, the oral administration of 100 mg of potassium iodide for 7 days induced a prominent increase of serum thyroid hormone level. These findings indicated that the metastatic thyroid carcinoma could produce excess thyroid hormone insofar as a sufficient amount of iodide was given. Although this is the first report of such a case, iodide-induced thyrotoxicosis may not be rare in patients with thyroid carcinomas because the Wolff-Chaikoff effect is thought to be lost, and the organic iodinating activity and lysosomal protease activity are well-preserved.

Acromegaly↗
PubMed1988

Nitroblue tetrazolium reduction by leukocytes in the cervix of pregnant women.

We examined nitroblue tetrazolium reduction activity in leukocytes from cervical mucus as well as peripheral blood from pregnant and nonpregnant women by histochemical methods. More than 90% of the cells examined were polymorphonuclear cells. Nitroblue tetrazolium reduction in polymorphonuclear cells from peripheral venous blood was significantly enhanced in pregnant women compared with that in nonpregnant women. However, there was no difference in activity between pregnancy periods. On the other hand, nitroblue tetrazolium reduction in cervical polymorphonuclear cells excluding women with cervicitis was also greater in pregnant women than in nonpregnant women. Moreover, activity in cervical polymorphonuclear cells gradually increased as pregnancy progressed. This enhanced activity in polymorphonuclear cells may be involved not only in the defense mechanism but also in cervical ripening in pregnancy.

Cervix Mucus↗
PubMed1988

The slope of fetal heart rate deceleration is predictive of fetal condition during repeated umbilical cord compression in sheep.

The relationship between components of fetal heart rate deceleration and fetal arterial blood gas values or plasma catecholamine concentrations was investigated by repeated complete umbilical cord compression in chronically instrumented fetal lamb. Fetal arterial pH and bicarbonate levels decreased, while plasma norepinephrine and epinephrine concentrations increased more than tenfold. The slope of the descending limb of the fetal heart rate deceleration curve decreased and correlated strongly with fetal arterial pH, bicarbonate, and logarithmic plasma norepinephrine and epinephrine concentrations. Fetal arterial pH and bicarbonate levels were significantly lower in the group with lower fetal heart rate deceleration slope, and a greater plasma catecholamine concentration in this group suggested a redistribution of blood flow to vital organs. Therefore, during repeated umbilical cord compression, the fetal acid-base and hormonal state was predicted by the fetal heart rate deceleration slope. This relationship may be applicable to human fetuses in the diagnosis of fetal distress caused by umbilical cord compression during labor.

Acidosis↗
PubMed1988

TSH dependent elevation of serum thyroglobulin in reversible primary hypothyroidism.

Serum levels of thyroglobulin (Tg) were measured using immunoradiometric assay in 18 patients with primary hypothyroidism, whose serum levels of thyroid stimulating hormone (TSH) were higher than 40 mU/l and anti-Tg antibodies were negative. In 12 patients, serum Tg levels were extremely elevated above the upper limit of normal (30 ng/ml) and the levels were more than 800 ng/ml in 10 of them. In all of these 12 patients, thyroid function recovered spontaneously with only iodide restriction and the serum Tg levels declined concomitantly with the decrease in serum TSH concentrations, events suggesting the TSH dependency of this Tg elevation. In the other 6 patients without elevated Tg levels, thyroid function did not recover and replacement therapy with L-thyroxine had to be given. Data from our study show that the TSH dependent Tg secretion is observed in reversible type primary hypothyroidism and that it may proceed vigorously even though thyroid hormone production is subnormal. Measurement of serum Tg may be valuable for predicting the prognosis of primary hypothyroidism.

Adult↗
PubMed1988

Thyroid amyloidosis with recurrent subacute thyroiditis-like syndrome.

We studied 2 men with a subacute thyroiditis-like syndrome (STLS) associated with systemic amyloidosis. Both had very tender, diffuse, firm goiters, low thyroidal radioactive iodine uptake values, and increased erythrocyte sedimentation rates. Glucocorticoid therapy resulted in dramatic improvement. Compared to 18 patients with subacute thyroiditis, these 2 men had 1) persistence of goiter even in remission, 2) repeated exacerbation of STLS, 3) pain always localized in the same site, and 4) gastrointestinal, renal, and cardiac abnormalities. Histological examination of the patients' thyroid glands revealed amyloid deposition and no evidence of subacute thyroiditis. In addition, 1 man had low T3 thyrotoxicosis with an elevated rT3/T3 ratio, suggesting impaired peripheral conversion of T4 to T3, and immunological and histological evidence of Hashimoto's thyroiditis. These findings suggest that thyroid amyloidosis may be associated with STLS. When patients with clinical features of subacute thyroiditis have an unusual course, the possibility of thyroid amyloidosis should be considered.

Adult↗
PubMed1988

Reevaluation of the thyroidal radioactive iodine uptake test, with special reference to reversible primary hypothyroidism with elevated thyroid radioiodine uptake.

The clinical significance of the thyroidal radioactive iodine uptake (RAIU) test was reevaluated in patients with various thyroid disorders. Compared with 262 normal subjects or 194 patients with euthyroid diffuse goiter with normal serum TSH levels, RAIU values were significantly higher in 100 patients with latent primary hypothyroidism (serum TSH, 5-40 mU/L). In 126 patients with overt primary hypothyroidism (serum TSH, greater than 40 mU/L), RAIU values were either extremely high (49 patients with reversible hypothyroidism and 10 patients with postpartum hypothyroidism) or low (67 patients with irreversible hypothyroidism). The increase in RAIU values in latent, or reversible overt hypothyroidism was TSH dependent, and there was a good correlation between RAIU values and serum TSH levels (r = 0.6203; P less than 0.001). In overt primary hypothyroidism, spontaneous recovery of thyroid function during iodide restriction alone occurred in 52 of 53 patients with RAIU values above 35%, in only 7 of 23 patients with RAIU values between 10-35%, and in none of 50 patients with RAIU below 10%. Thus, recovery was predicted by high RAIU values (P less than 0.001; prediction rate, 91.4%). Goiter was found in about 80% of the patients with reversible hypothyroidism, compared with only 34% of the patients with irreversible hypothyroidism. Recovery of thyroid function during iodide restriction also occurred in 71% of the patients with latent hypothyroidism. However, RAIU measurements did not predict the prognosis of patients with latent hypothyroidism. We conclude that iodine-induced reversible hypothyroidism is common in our patient population, and RAIU measurements may be helpful in determining the prognosis of patients with overt primary hypothyroidism.

Adult↗
PubMed1988

Human cytotrophoblastic antigens defined by monoclonal antibodies.

Monoclonal antibodies have been raised against cytotrophoblast. Two different antigens, defined on cytotrophoblast but not on syncytiotrophoblast were designated ACT-1 and ACT-2, respectively. Chorionic villi were taken from normal early pregnancy and processed for immunization by two different procedures. ACT-1 was demonstrated to be present in lung alveolar cells, endothelial mucosa of the jejunum, colon, ureter, urinary bladder and the fallopian tube, and endometrial gland of the pregnant uterus. On the other hand, ACT-2 was present in the endothelial mucosa of the stomach, endothelium of the renal vessel, and the decidua of the pregnant uterus. Although the monoclonal antibodies did not react with such established cell lines as Bewo, SCH, OVK-18, HHUA, MK-01, FL, BHK and P3 X 63Ag 8 . 653, they did react with some of the cell lines when the cell membrane was destroyed with Triton X-100. Each antibody, therefore, may recognize the antigen not on the cell membrane but in the cytoplasm. The antigens might be shed or may disappear in the process of differentiation from cytotrophoblast to syncytiotrophoblast.

Antibodies, Monoclonal↗
PubMed1988

Three cases of fetal ascites with successful outcome and seven year evaluation of NIHF: 1981-1987.

Three pregnant women with fetal ascites were admitted to our hospital at 30, 32 and 33 weeks of gestation on diagnosis by sonogram. On sonogram, all the fetuses were initially with marked ascites but without any pleural or pericardial effusion or subcutaneous edema. Under observation by sonogram and cardiotocogram, obstetrical intervention was performed by cesarean section in all 3 cases; at 31 weeks of gestation due to notably increased ascites, at 32 weeks due to fetal distress and at 35 weeks due to development of subcutaneous edema, respectively, and the subsequent courses were uneventful. On the other hand, in our precious experience with 21 cases of NIHF over a period of 7 years, only 2 babies with NIHF have been born alive. We think fetal ascites should be considered an initial sign of NIHF and the successful outcome of these three cases were due to early diagnosis by frequent sonographic examination.

Adult↗