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Biomedical subjects

K Oshima

Publications and source records attributed to K Oshima.

At least 73 records · Page 4Linked to original sources

Growth of the pulmonary arteries after systemic-pulmonary shunt.

Pulmonary artery growth after a systemic-pulmonary shunt was angiographically evaluated in 19 out of 35 patients. The mean age of the subjects at the time of the initial operation was 18+/-18 months including 12 patients under a year old. The preoperative diagnosis was tetralogy of Fallot (TOF) in 10 patients, TOF plus pulmonary atresia in five and transposition of great arteries in four. A Blalock-Taussig shunt (BTS) operation was performed in 16 patients (15 classical and 1 modified) and a central shunt was performed in three patients as an initial operation. The preoperative pulmonary artery index (PAI) was 129+/-42 in all patients and there were no significant differences between patients under or over a year old (139+/-42 vs. 115+/-49). Postoperative angiography was performed 32+/-13 months after the surgery. Room air arterial O2 pressure increased significantly from 29+/-5 mmHg to 42+/-5 mmHg just after an initial palliative shunt operation. PAI change in patients under a year old was 214+/-73%, which was higher than 145+/-27% in patients over a year old after a palliative shunt operation. On the ipsilateral side, PAI change was almost the same between patients under and over a year old. On the contralateral side, PAI change in patients under a year old was 216+/-68%, which was significantly higher than the 116+/-21% in patients over one year old. There was a significant negative correlation (r=-0.65, p<0.05) between PAI change and arterial O2 pressure as measured just after a palliative shunt operation. In conclusion, a palliative shunt operation prior to a year old is desirable in order to produce sufficient and bilateral pulmonary artery growth.

Anastomosis, Surgical↗

Primary CD30/Ki-1 positive anaplastic large cell lymphoma of skeletal muscle with der(17)t(1;17)(q11;p11).

CD30/Ki-1 positive anaplastic large cell lymphoma (Ki-1 ALCL) frequently exhibits extranodal disease and chromosomal t(2;5)(p23;q35). An 11-year-old girl presented with an intramuscular tumor of the right upper arm. Tumors of the chest wall, left arm and leg, hepatomegaly, pleural effusion, and enlarged lymph nodes then developed. The intramuscular tumor and pleural effusion showed a diffuse infiltration of large atypical cells with abundant amphophilic cytoplasms. The tumor cells were positive for CD30, CD2, CD45RO, and p80, but were negative for other T-cell, B-cell, and myeloid cell antigens. She was diagnosed as having Ki-1 ALCL with a T-cell origin. Cytogenetic studies showed an abnormal karyotype including a der(17)t(1;17)(q11;p11). She received seven cycles of intensive chemotherapy followed by an autologous peripheral blood stem cell transplantation, and has been in complete remission for more than two years. The primary involvement of skeletal muscle is quite uncommon in ALCL, and an abnormal karyotype including t(1;17)(q11;p11) has not been reported previously. Since a high frequency of aberrations of 1p36/1q12 or 17p13.3 was detected in sarcoma cells, the presence of suppressor genes is suggestive in these sites.

Child↗

Et(3)B-Induced Hydrogermylation of Alkenes and Silyl Enol Ethers.

Tri-2-furanylgermane in the presence of a catalytic amount of Et(3)B adds to internal alkenes as well as terminal alkenes effectively to give the corresponding adducts in good to excellent yields. The addition of tri-2-furanylgermane to silyl enol ethers followed by elimination of germyl and siloxy moieties provides a new route for the conversion of ketones into alkenes.

Journal Article↗

Rapid progression of intrahepatic cholangiocarcinoma after drainage of large cystic lesions: report of a case.

We report herein a case of cholangiocarcinoma with large cystic lesions. Computed tomography (CT) demonstrated large cysts in segment IV and the paracaval portion of the caudate lobe, and a solid tumor in the anterior segment of the right lobe of the liver which was contiguous to the cyst in the paracaval portion of the caudate lobe. The large cysts were diagnostically misleading and a liver abscess was suspected. Thus, percutaneous transhepatic drainage of the cyst was performed. The fluid in the cyst was negative bacteriologically, but malignant cells were detected. A CT scan done 2 weeks after drainage of the cyst showed progression of the solid tumor with intrahepatic metastasis and replacement of the cystic lesions by the solid tumor. Following percutaneous transhepatic portal embolization, a right hepatic trisegmentectomy with caudate lobectomy was performed. Pathological examination confirmed cholangiocellular carcinoma. These results indicate that drainage of the cystic lesion induced the tumor progression in the liver. Therefore, the possibility of cholangiocarcinoma with a large cystic lesion should be borne in mind when considering the differential diagnosis of a cystic lesion in the liver, and appropriate surgical therapy should be carefully selected.

Aged↗

Molecular cloning of a novel human gene (SIRP-B2) which encodes a new member of the SIRP/SHPS-1 protein family.

A full-length cDNA encoding a novel protein was isolated and sequenced from a human placental cDNA library. This cDNA consists of 1,735 base pairs and has a predicted open reading frame (ORF) encoding 354 amino acids. It possesses a putative signal sequence, a long extracellular domain, a transmembrane region, a short intracellular domain, and no catalytic domain, which is highly homologous to signal-regulatory protein (SIRP)-beta suggesting that it seems to be a new member of the SIRP family. Polymerase chain reaction (PCR)-based mapping with both a monochromosomal hybrid panel and radiation hybrid cell panels placed the gene to human chromosome 20p13 near the marker D20S906.

Amino Acid Sequence↗

Clinical results of fetal obstructive uropathy treated by vesicoamniotic shunting.

OBJECTIVES: To report the clinical results of 5 fetuses after a vesicoamniotic shunting procedure (VASP). METHODS: Between 1995 and 1998, 5 patients (two with prune belly syndrome, one with a cloacal anomaly, one with urethral stenosis, and one with a sacrococcygeal teratoma) underwent VASP using a double-basket catheter. We used the following selection criteria: a fetus without chromosomal defects, with oligohydramnios, and with a predicted good renal function from sequential or single fetal urinalysis (sodium concentration, chloride concentration, and osmolarity at less than 100 mEq/L, less than 90 mEq/L, and less than 210 mOsm, respectively). RESULTS: The mean gestational age was 20.8 +/- 6.9 weeks at diagnosis, 24.2 +/- 6.0 weeks at VASP, and 30.6 +/- 6.2 weeks at delivery. In our study, 2 of 5 patients survived. One of the patients with prune belly syndrome was 18 months old at last follow-up, with hydrocephalus and a creatinine level of 0.2 mg/dL. The patient with the cloacal anomaly was 4 years old at last follow-up and had signs of clonic convulsion. However, psychomotor development was delayed in both. Of the 3 patients who died, 2 died after birth, and the autopsy determined death was due to pulmonary insufficiency. The patient with urethral stenosis died in utero. CONCLUSIONS: Although the principal purpose of VASP is to prevent pulmonary hypoplasia and dysfunctional kidneys, VASP was not always effective, as the outcomes were poor in most of our patients. A greater standardization of patient selection and a large cohort study in the future should be considered to assess VASP.

Amnion↗

Vitrectomy for macular hemorrhage associated with retinal arterial macroaneurysm.

OBJECTIVE: To evaluate the safety and efficacy of pars plana vitrectomy to treat massive macular hemorrhage caused by retinal arterial macroaneurysm. DESIGN: Retrospective case series. PARTICIPANTS: Eight eyes of eight patients. METHODS: We retrospectively reviewed the charts for eight eyes of eight patients in which pars plana vitrectomy had been performed to remove a massive macular hemorrhage secondary to a ruptured retinal arterial macroaneurysm. In each case, the preretinal/intralamellar hemorrhage was removed, and in three of the eight eyes a subretinal hemorrhage was removed via a retinotomy after clot lysis using tissue plasminogen activator. MAIN OUTCOME MEASURE: Pars plana vitrectomy to treat macular hemorrhage secondary to retinal arterial macroaneurysm. RESULTS: The duration of symptoms ranged from 10 to 80 days (average, 31 days). The preoperative visual acuities ranged from counting fingers to 0.09. Follow-up ranged from 3 to 36 months (average, 19 months). The postoperative visual acuities improved in seven eyes and remained unchanged in one; vision was better than 0.1 in six eyes and better than 0.4 in five. Postoperative complications included a mild vitreous hemorrhage in two eyes, a macular hole in one, and a cataract in two. CONCLUSIONS: Pars plana vitrectomy appears to be relatively safe and effective in treating massive macular hemorrhage caused by a retinal arterial macroaneurysm.

Aged↗

FK409 ameliorates ischemia-reperfusion injury in heart transplantation following 12-hour cold preservation.

OBJECTIVE: FK409 is the first spontaneous nitric oxide donor to increase plasma guanosine 3':5'-cyclic monophosphate. We designed this study to investigate whether the administration of FK409 during reperfusion ameliorated ischemia-reperfusion injury and enhanced post-transplant graft function in orthotopic heart transplantation following 12-hour cold preservation in a canine model. METHODS: We used 10 pairs of adult mongrel dogs, weighing 9.5 to 13.5 kg. Following cardiac arrest using cardioplegia, we washed out the coronary vascular beds with cold University of Wisconsin solution followed by 12-hour preservation. After preservation, we performed orthotopic transplantation. The experimental animals were divided into 2 groups. In the FK group (n = 5), FK409 (5 microg/kg/min) was administered intravenously, beginning 15 minutes before the onset of reperfusion and continuing for 45 minutes after reperfusion. In the control group (n = 5), saline vehicle was administered in the same manner. Two hours after transplantation, we assessed cardiac function, including cardiac output, left ventricular systolic pressure (LVP), and the maximum rates of positive and negative increase of LVP (+/-LV dP/dt) by comparing the recovery rate (%) of the cardiac function of the donor animal. We measured endothelin-1 levels in blood obtained from a catheter inserted into the coronary sinus 30, 60, and 120 minutes after reperfusion. RESULTS: Cardiac output was higher in the FK group than in the control group, but the difference was not significant (p = 0.08). Left ventricular systolic pressure and +/-LV dP/dt were significantly (p < 0.05) higher in the FK group than in the control group. Endothelin-1 levels were significantly (p < 0.05) lower in the FK group than in the control group 30 minutes after reperfusion. Transmission electron microscopy showed that the basal lamina of capillary vessels, glycogen granules, and mitochondrial structure were well-preserved in the FK group. CONCLUSIONS: In orthotopic transplantation models, FK409 is effective in ameliorating ischemia-reperfusion injury following preservation and in enhancing post-transplant cardiac function.

Adenosine↗

Myopericarditis caused by cyclophosphamide used to mobilize peripheral blood stem cells in a myeloma patient with renal failure.

Cyclophosphamide (CPA) is widely used for peripheral blood stem cell mobilization, and a dose adjustment of CPA in the presence of renal failure has not been suggested. However, we describe a myeloma patient with renal failure (serum creatinine 4.2 mg/dl, creatinine clearance 11.2 ml/min) receiving CPA 2 g/m2 for 2 days, who developed unexpectedly severe toxicity, including myopericarditis and prolonged myelosuppression. The serial serum concentrations of CPA metabolites were persistently much higher than those in a myeloma patient with normal renal function. We consider, therefore, that the dose of CPA should be reduced in the presence of severe renal failure when used as high-dose therapy or to mobilize peripheral blood stem cells.

Adult↗