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Biomedical subjects

K Otsuka

Publications and source records attributed to K Otsuka.

At least 145 records · Page 8Linked to original sources
PubMed1999

Limb-sparing surgery with reinnervated free-muscle transfer following radical excision of soft-tissue sarcoma in the extremity.

Limb-sparing surgery is the preferred approach in the management of patients with high-grade soft-tissue sarcomas when local disease can be completely resected. However, conventional treatment focuses only on restoration of basic functions to the remnant limb. Lost functions are not restored to normal, leaving the patient with variable degrees of functional disabilities. This in turn may necessitate further massive reconstructive procedures. Transferred reinnervated free muscles were used to reconstruct functions lost after radical resection of malignant soft-tissue sarcoma of the extremities in 17 patients. The long-term functional outcome included survival of transplanted muscle, speed of neural recovery, and muscle strength and disabilities. All muscles survived. Postoperative follow-up ranged from 27 to 106 months. All muscles except those in a 75-year-old patient were successfully reinnervated. Powerful strength and almost normal limb functions were obtained. Functional scoring of the patients according to the rating system of the Musculoskeletal Tumor Society was 87 percent for the lower extremity and 93 percent for the upper extremity. All patients are presently disease-free. Use of the reinnervated free-muscle transfer in limb-sparing surgery after resection of soft-tissue sarcoma in the extremity may be indicated in the young adult when radical excision of the tumor will result in severe motor functional loss, provided adequate clearance can be obtained and that there is no presence of distant metastasis.

Adolescent↗
PubMed1999

Rationale for time-qualified reference standards for 24-hour blood pressure values and their circadian rhythms in Japanese normotensive adults: a study by the Ambulatory Blood Pressure Monitoring Research Group.

The aim of this study was to demonstrate that blood pressure (BP) has to be standardized according to its circadian variability, including the properties shown in its circadian rhythm. The BP time-qualified standards were derived from a sample of 644 clinically healthy normotensive Japanese subjects (320 males, 324 females; age range, 18-93 years), stratified by age-group and gender, who underwent noninvasive ambulatory monitoring according to a fixed protocol. The monitored data series shows that BP exhibits a within-day variability at any age of life in both males and females. Additionally, the monitored data series shows that BP exhibits a significant circadian rhythm at any age of life in both males and females. The age- and sex-related reference limits for the BP within-day variability constitute the time-qualified standards against which both the casual and monitored BP measurements can be compared in order to detect whether or not they are compatible with normotension. The reference limits for the BP circadian rhythm represent the rhythmometric standards against which the BP oscillatory curve can be compared in order to detect whether or not they are compatible with a physiological circadian rhythm.

Adolescent↗
PubMed1999

Intra-articular fractures of the distal aspect of the radius: arthroscopically assisted reduction compared with open reduction and internal fixation.

BACKGROUND: There is no consensus that an arthroscopically guided operation can improve the anatomical and functional results of treatment of intra-articular fractures of the distal aspect of the radius. The purpose of the present prospective study was to determine the usefulness of arthroscopically assisted reduction of displaced intra-articular fractures of the distal aspect of the radius by comparing the results of that procedure with those of conventional open reduction and internal fixation. METHODS: Thirty-four fractures were treated with arthroscopically guided reduction with use of one volar and two dorsal arthroscopic portals. The fractures were pinned, and external fixation was used with or without autogenous bone graft. Intraoperative fluoroscopy was not used. Forty-eight fractures were treated with conventional open reduction and internal fixation with a plate and screws or with pinning, with or without external fixation. The average duration of follow-up for all fractures was thirty-one months. RESULTS: The scores for overall outcome, assessed with use of the system of Gartland and Werley and that of Green and O'Brien as modified by Cooney et al., demonstrated that the group that had had an arthroscopically assisted procedure had better outcomes than the group that had had conventional open reduction and internal fixation. The group that had had an arthroscopically assisted procedure also had significantly better ranges of flexion-extension and radial-ulnar deviation of the wrist and grip strength (p<0.05). We detected an association between the maximum step and gap displacement and evidence of osteoarthritis of the radiocarpal joint (p<0.001), but we did not find a significant association, with the numbers available, between the scores for osteoarthritis, graded according to the scale of Knirk and Jupiter, and the scores for overall outcome, assessed with the scale of Gartland and Werley and the modified system of Green and O'Brien, in either group (p = 0.376). The radiographic results showed that the patients who had had an arthroscopically assisted procedure had better reduction of volar tilt, ulnar variance, and articular (gap) displacement than did those who had been managed with conventional open reduction and internal fixation (p<0.05 for each comparison). CONCLUSIONS: An arthroscopically guided operation achieved an accurate reduction of intra-articular fractures of the distal aspect of the radius. Minimum capsular and adjacent soft-tissue scarring reduced postoperative contracture, which improved the overall functional results. We recommend arthroscopically guided reduction and internal fixation not only for young adults but for all patients who are less than seventy years old and have an intra-articular fracture of the distal part of the radius with more than one millimeter of displacement on plain radiographs.

Adolescent↗
PubMed1999

47,XX,UPD(7)mat,+r(7)pat/46,XX,UPD(7)mat mosaicism in a girl with Silver-Russell syndrome (SRS): possible exclusion of the putative SRS gene from a 7p13-q11 region.

Maternal uniparental disomy for chromosome 7 (UPD7) may present with a characteristic phenotype reminiscent of Silver-Russell syndrome (SRS). Previous studies have suggested that approximately 10% of SRS patients have maternal UPD7. We describe a girl with a mos47,XX,+mar/46,XX karyotype associated with the features of SRS. Chromosome painting using a chromosome 7 specific probe pool showed that the small marker was a ring chromosome 7 (r(7)). PCR based microsatellite marker analysis of the patient detected only one maternal allele at each of 16 telomeric loci examined on chromosome 7, but showed both paternal and maternal alleles at four centromeric loci. Considering her mosaic karyotype composed ofdiploid cells and cells with partial trisomy for 7p13-q11, the allele types obtained at the telomeric loci may reflect the transmission of one maternal allele in duplicate, that is, maternal UPD7 (complete isodisomy or homodisomy 7), whereas those at the centromeric loci were consistent with biparental contribution to the trisomic region. It is most likely that the patient originated in a 46,XX,r(7) zygote, followed by duplication of the maternally derived whole chromosome 7 in an early mitosis, and subsequent loss of the paternally derived ring chromosome 7 in a subset of somatic cells. The cell with 46,XX,r(7) did not survive thereafter because of the monosomy for most of chromosome 7. If the putative SRS gene is imprinted, it can be ruled out from the 7p11-q11 region, because biparental alleles contribute to the region in our patient.

Chromosomes, Human, Pair 7↗
PubMed1999

[Design and development of one-handed denture brush for bedridden people].

Oral care for elderly bedridden people is one of the most necessary forms of care, not only for prevention of oral infection or aspiration pneumonia, but also in order to savor the taste of food and to recover and maintain mental vitality through the improvement in oral function. We designed denture brush that can be handled with one-hand in order to support independence. People require cooperation between medical treatment, health, and welfare services. We introduced the newly designed denture brush as a means to support the improvement of QOL for elderly bedridden people, and we hope to see the spread and promotion of oral care.

Activities of Daily Living↗
PubMed1998

Effects of compositions of dimethyl-beta-cyclodextrins on enantiomer separations by cyclodextrin modified capillary zone electrophoresis.

In enantiomeric separation by capillary zone electrophoresis using dimethyl-beta-cyclodextrin (DM-beta-CD) as a chiral selector, enantioselectivities were sometimes significantly different among DM-beta-CDs from five different suppliers. The reason was due to the difference in the compositions among these commercial products, which was shown by the liquid chromatographic (LC) analysis. As for commercial DM-beta-CD from one supplier, two major components were obtained by preparative LC. NMR spectroscopic and mass spectrometric analyses of these two components were performed to estimate the structure of each component. The results implied that the commercial products consist of heptakis(2,6-di-O-dimethyl)-beta-CD and hexakis(2,6-di-O-methyl)-mono(2,3,6-tri-O-methyl)-beta-CD. Sometimes different enantioselectivities were observed between these two components including the original DM-beta-CD.

Chromatography, Liquid↗
PubMed1998

On-line concentration of neutral analytes for micellar electrokinetic chromatography. VI. Stacking using reverse migrating micelles and a water plug.

Utility of a second enhanced field zone (water zone) is investigated for the on-line concentration of neutral analytes in micellar electrokinetic chromatography. Micellar solutions of sodium dodecyl sulfate prepared in acidic phosphate buffers are used as separation and sample solutions. Prior to long hydrodynamic injection of samples prepared in a low conductivity matrix, a long water plug is hydrodynamically injected to provide a second enhanced field zone. Practical and some fundamental considerations are presented. The technique is selective towards hydrophobic analytes. Notable detector response improvements (>100-fold) for several analytes are observed experimentally.

Chromatography, Micellar Electrokinetic Capillary↗
PubMed1998

Infrequent frameshift mutations of polynucleotide repeats in multiple primary cancers affecting the esophagus and other organs.

Frequent frameshift mutations of simple nucleotide repeats in the protein-encoding regions, as well as replication errors (RERs) at microsatellite loci, have recently been demonstrated in gastrointestinal tumors. These genetic instabilities have been considered indicative of an increased risk of accumulating mutations in cancer-associated genes and of developing multiple cancers. We studied frameshift (or insertion/deletion) mutations of simple nucleotide repeats in five genes (TGFbeta type II receptor [TGFbetaRII], E2F4, MSH2, MSH3, and MSH6) in 23 tumors from 12 patients who had synchronous cancers of the esophagus and other organs. Genetic instability at four microsatellite loci, as well as mutations in the TP53, APC, and KRAS2 genes, were also studied. No frameshift mutations were observed in the TGFbetaRII, MSH3, and MSH6 genes. RER and a deletion mutation of BAT26 in MSH2 were present in one (1/23; 4%) gastric cancer. This tumor also carried a deletion mutation in the serine (AGC) repeat of the E2F4 gene. Mutation screening of the TP53, APC, and KRAS2 genes revealed that the synchronous cancers did not carry the same mutations. Our results suggested that genetic instability, such as insertion/deletion mutations in simple nucleotide repeats, is not significantly associated with the development of multiple primary cancers of the esophagus and other organs, and that these synchronous cancers developed independently according to their different environmental factors.

Colonic Neoplasms↗
PubMed1998

Idiopathic renal arteriovenous fistula demonstrating a huge aneurysm with a high risk of rupture: report of a case.

This paper reports a case of an idiopathic renal arteriovenous fistula demonstrating a huge guitar-shaped aneurysm, which required a total nephrectomy. Although the patient insisted on having been asymptomatic, echocardiography and cardiac catheterization clearly revealed that the influence on hemodynamics was unexpectedly significant. Interestingly, the aneurysm was also considered to have a high risk of rupture, which was preoperatively suggested by an aneurysm wall projection discernible on both computerized tomograms and angiograms, and this suspicion was also convincingly supported by the perioperative and histopathological findings.

Aneurysm↗
PubMed1998

Protein carboxyl methylation controls intracellular pH in human platelets.

OBJECTIVES: Carboxyl methylation is a reversible post-translational event which regulates the function of several cellular proteins. Because the human Na+-H+ antiporter (NHE-1) possesses a C-terminal consensus sequence for carboxyl methylation, we examined the role of protein carboxyl methylation in the regulation of intracellular pH homeostasis. DESIGN: Experiments were conducted using human platelets and N-acetyl-S-trans,trans-farnesyl-L cysteine (AFC), a specific prenylcysteine methyltransferase inhibitor. The effect of AFC on both basal intracellular pH (pHi) and on the kinetic properties of the Na+-H+ antiporter was characterized. MATERIALS AND METHODS: pHi was determined in cell suspensions using 2,7-biscarboxyethyl-5(6)-carboxyfluorescein tetraacetoxymethyl ester, a fluorescent pH indicator. The kinetics properties of the Na+-H+ antiporter activity were determined using platelets acidified with nigericin and challenged with varying extracellular concentrations of Na+. RESULTS: AFC (20 micromol/l) decreased basal pHi significantly (7.047 +/- 0.011 versus 7.133 +/- 0.012 for control, P< 0.001). The acidification was dose-dependent and reached steady state 3 min after AFC addition. In the absence of extracellular Na+, the platelets were acidified to the same extent with AFC or with ethanol (control): 6.530 +/- 0.031 versus 6.532 +/- 0.031 (P= 0.97). However, upon addition of Na+, the platelets treated with AFC showed a significant decrease in the maximal value for initial pHi recovery compared with controls: 0.788 +/- 0.041 versus 0.983 +/- 0.047 pH/min (P< 0.02). AFC also increased the Hill coefficient (2.89 +/- 0.22 versus 2.14 +/- 0.16, P < 0.03), and tended to decrease K0.5, the [Na+] corresponding to half-maximal activation (51.3 +/- 1.8 versus 60.5 +/- 3.9 mmol/l, P = 0.06) of the antiporter. CONCLUSION: Our data indicate that inhibition of carboxyl methylation reduces basal pHi and alters the kinetic properties of the Na+-H+ antiporter in human platelets, suggesting that carboxyl methylation is implicated in the regulation of intracellular pH homeostasis.

Acetylcysteine↗
PubMed1998

Free muscle transfer can restore hand function after injuries of the lower brachial plexus.

One pattern of injury to the brachial plexus shows recovery of the fifth and sixth cervical nerves but little else. These patients have useful shoulders and functional elbow flexion, but elbow and wrist extension is weak or absent. Their hand function is negligible. We restored hand function in three such patients using free functioning muscle transfer for finger flexion and transfer of the sensory rami of the intercostal nerve to the ulnar nerve for sensation. Supplementary operations to restore elbow and wrist extension were necessary in one patient.

Adult↗
PubMed1998

[Method of quantitative measurement of human platelet aggregation in clinical practice].

We examined the quantitative measurement of platelet aggregation in 20 volunteers and 89 patients with ischemic heart disease (IHD). Subjects in whom platelet aggregation was induced by an adenosine diphosphate (ADP and an epinephrine solution were clearly divided into two groups: "normal" and "accentuated". We chose the maximum aggregation time for the ADP solution and the maximum transmission rate for the epinephrine solution for the quantitative measurement of platelet aggregation. The results were as follows. The maximum aggregation time with a 1.0 microM ADP solution in the normal group of 13 volunteers was 0.71 +/- 0.12 min, (mean +/- SD), in 50 IHD patients it was 0.91 +/- 0.49 min, in the "accentuated" group of 7 volunteers it was 5.34 +/- 1.18 min, in 39 IHD patients it was 6.01 +/- 1.22 min. The maximum light transmission rate with a 0.1 microM epinephrine solution in the normal group of 14 volunteers was 8.04 +/- 4.14%, in 52 IHD patients it was 13.74 +/- 5.75%, in the "accentuated" group of 6 volunteers it was 76.33 +/- 9.91%, and in 37 IHD patients it was 77.26 +/- 13.39%. The difference between the "normal" and "accentuated" groups was statistically significant (p < 0.001), with the ADP and with the epinephrine solution. Next, we examine the effect of antiplatelet therapy (dipyridamole and aspirin) on 15 patients selected from among those with IHD who had accentuated platelet aggregation when the ADP solution was added. Their maximum aggregation time was 5.98 +/- 1.24 min, and their maximum platelet aggregation rate when the epinephrine solution was added was 78.90 +/- 11.60% (10 patients), 20.00 +/- 3.24% (5 patients). After the therapies, the maximum aggregation time in 10 patients was 0.94 +/- 0.21 min (return to normal condition), and in 5 patients it was 5.90 +/- 1.09 min (not effective). The maximum platelet aggregation rate in 10 patients was 14.11 +/- 5.88% (normal condition), and in 5 patients it was 75.00 +/- 9.51% (not effective). Finally, we examined the long term effects of various antiplatelet drugs. Most of the patients in whom platelet aggregation was accentuated got well.

Adenosine Diphosphate↗
PubMed1998

[Pagetoid spread of intratubular germ cell neoplasia into rete testis forming tumor-like mass].

Intratubular germ cell neoplasia (ITGCN) is the preinvasive phase of testicular germ cell tumors. ITGCN can spread into the rete testis in a pagetoid manner, but there are very few published data about this phenomenon. Furthermore, the tumor-like mass formed by ITGCN with pagetoid spread into the rete testis has not been documented to date, and the present case is the first to be reported. A tumor-like mass was found close to the superior pole of the left testis in a 39-year-old male and was unrelated to the epididymis. Three other nodules of seminoma surrounded by fibroconnective tissue existed next to the mass. Histological sections revealed ITGCN which was characterized by the presence of large and polygonal germ cells exhibiting clear cytoplasm with distinct cell borders. The cytoplasm was rich in glycogen and the cell membrane was immunohistochemically positive for placental alkaline phosphatase. The nuclei had less coarse chromatin than that of seminoma. ITGCN cells spread in between the lining epithelium of the rete and the basement membrane. This characteristic spread was consistent with pagetoid spread into the rete testis.

Adult↗
PubMed1997

Micelles as pseudo-stationary phases in micellar electrokinetic chromatography.

This review article describes some general comments on micellar electrokinetic chromatography (MEKC) from the viewpoint of pseudo-stationary phases and presents a compiled list of surfactants used for MEKC, prepared from published papers. We tried to give comments on some typical surfactants from the practical point of view.

Electrophoresis, Capillary↗