Search PubMed⌕ Search

Biomedical subjects

K Sakai

Publications and source records attributed to K Sakai.

At least 865 records · Page 48Linked to original sources
PubMed1991

[Asbestos concentration and fiber size in lungs of the urban residents].

Asbestos fiber concentrations and fiber size distribution in lung tissues of 53 urban residents (males: 34, female: 19) were analyzed by low temperature ashing-analytical transmission electronmicroscopy. The following findings were obtained. 1. Pulmonary asbestos fibers were found in 51 out of 53 patients. The types of asbestos fibers were chrysotile, amosite, crocidolite, actinolite and tremolite. 2. Thirty-six of 53 patients had no history of occupational asbestos exposure, and their geometric mean concentration of asbestos fibers was 1.67 x 10(6) fibers/g dry lung. Most of these asbestos fibers are probably attributable to general environmental contamination. Thirteen patients who had a history of occupational asbestos exposure showed a geometric mean of their pulmonary asbestos concentrations (5.82 x 10(6) fibers/g dry lung) which was significantly higher than that of patients without occupational asbestos exposure (p less than 0.01). 3. The geometric mean concentration of asbestos fiber in males (2.70 x 10(6)) was higher than in females (1.59 x 10(6)), probably due to a difference in the occupational asbestos exposure between males and females. 4. Regardless of the patient's sex, the geometric mean concentration of asbestos fibers in patients without a history of smoking (male: 4.91 x 10(6), female: 1.78 x 10(6)) was higher than that in patients with a smoking history (male: 2.76 x 10(6), female: 1.37 x 10(6)). The difference, however, was not statistically significant, and no correlation was seen between the concentration of asbestos fibers and smoking history. 5. Although most asbestos fiber utilized in Japan is chrysotile, the geometric mean concentration of chrysotile (0.87 x 10(6)) was almost identical to that of amphibole asbestos fiber (0.90 x 10(6)). 6. Of the asbestos fibers observed, 95% of chrysotile and 85% of amphibole asbestos were less than 5 microns in length and 93% of the total asbestos fibers were too small to be visible by light microscopy.

Adult↗
PubMed1991

[A high serum level of interleukin-6 in a patient with aggressive multiple myeloma].

A 58-year-old female was admitted to our hospital because of anemia in March 1987. Monoclonal protein (IgA, kappa) was detected and a diagnosis of multiple myeloma was made. Partial remission was obtained after VAD therapy with alpha-interferon. In December 1989, she was readmitted because of a pathological fracture of the left humerus. A white blood cell count was 4400/microliters with 30% myeloma cells and the urine protein (Bence Jones protein) was 26 g/day. Systemic chemotherapy was not effective. She developed pleural and pericardial effusions, bone mass, disturbance of consciousness and died of respiratory failure only 3 months after readmission. The pleural and pericardial fluids contained many myeloma cells. c-myc gene rearrangement was detected in myeloma cells obtained from the pleural fluid using c-myc exon1 and exon2 probes. The levels of interleukin-6 (IL-6) measured by ELISA was 107.4 pg/ml in serum, 56.2 pg/ml in pleural fluid and 780.0 pg/ml in pericardial fluid. Because of the lack of any overt infectious focus, the level of IL-6 appears to have been related to aggressive proliferation of myeloma cells. It was of interest that C-reactive protein, induced by IL-6, was a good marker reflecting disease activity.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1991

[Clinical investigation on the adjunctive method in the surgery of thoracic aortic aneurysms--comparison of the temporary bypass and partial extracorporeal bypass].

Since 1980, two different operative strategies were employed during resection to provide distal aortic perfusion by temporary bypass (Group "TB", 39 patients) or partial extracorporeal bypass (Group "PEC", 39 patients) in the operation for the thoracic descending aortic aneurysms or the dissecting aortic aneurysms with DeBakey type III. No significant differences were found in the patient population or the operative procedures between two groups. Mean bypass flow in Group "PEC" was 1850 +/- 70 (ml/min), which is significantly higher than in Group "TB" (1000 +/- 240 ml/min). However, there were no significant differences in the distal aortic pressure between two groups, which was due to administration of vasodilators. Platelet counts in Group "PEC" were significantly lower in the postoperative courses, probably caused by the use of roller pumps or suckers. The incidence of the postoperative renal dysfunction was almost the same in two groups. Cardiac functions during temporary bypass were suppressed by the aortic cross-clamping, therefore, it is necessary to evaluate the cardiac function preoperatively in employing this method. Partial extracorporeal bypass has the disadvantages of the requirement for full heparinization, but it can be indicated to almost all cases, even to the patients with poor cardiac function. It also has the advantage to maintain the distal perfusion in the unexpected intraoperative situations. The method of distal aortic perfusion should be determined by patient-related and disease-related factors.

Aged↗
PubMed1991

[Successful surgical management of postinfarction ventricular septal perforation in an 85-year-old woman].

The patient was an 85-year-old woman who developed chest pain on August 6, 1989, and was admitted to our hospital the next day. The diagnosis was acute inferior myocardial infarction. Her general condition was good at first; however, a harsh holosystolic murmur was suddenly heard 13 hours after the onset of infarction. Immediate cardiac catheterization revealed a ventricular septal perforation with a 2.2:1 shunt and total occlusion of the posterior descending artery. IABP was started 3 days after the onset of perforation. PCWP and shunt ratio decreased after starting IAPB; however, lung congestion continued to worsen. An emergency operation was performed on the 5th day after the onset of perforation. The post-operative course was uneventful. She is presently doing well 17 months after the surgery. Seven patients more than 80 years old have been surgically treated for postinfarction ventricular septal perforation in Japan and this patient is the oldest.

Aged↗
PubMed1991

[A case report of right ventricular myxoma which was found by cardiac systolic murmur at a medical examination].

Right ventricular myxoma is very rare with the only 19 cases in the Japanese literature. We report on a 26-year-old woman with a right ventricular myxoma which was found by cardiac systolic murmur at a medical examination and successfully excised. Echocardiography and coronary angiography is very useful in deciding the location of insertion on the right ventricle. Right atriotomy prior to right ventriculotomy was important for right ventriculotomy and necessary for complete excision. Clinical characteristics, and diagnostic and therapeutic aspects are discussed.

Adult↗
PubMed1991

Fluorescence demonstration of cathepsin B activity in fractionated alveolar macrophages.

Histochemical localization of cathepsin B in alveolar macrophages (AM) that separated into four different density fractions (I, II, III and IV) by discontinuous Percoll gradient centrifugation was demonstrated in fluorescence microscope using CBZ-Arg-Arg-4-methoxy-2- naphthylamide as a substrate and 5-nitrosalicylaldehyde as a coupling reagent. The least dense AM (fraction I) was found numerous bright yellow fluorescing particles with high intensity in small granules distributed throughout the cytoplasm when compared to the most dense cells (fraction IV). The different localization of cathepsin B activity in the fractionated cells suggested differentiation of lysosomal system and existence of maturational (or aging) sequence in rat AM.

Animals↗
PubMed1991

Hepatic venous oxygen saturation monitoring in patients with assisted circulation for severe cardiac failure.

In order to assess the adequacy of hepatic perfusion, hepatic venous oxygen saturation (ShvO2) was monitored in five patients undergoing mechanical circulatory support. Two patients were with intra-aortic balloon pumping (IABP), one was with a left ventricular assist device (LVAD), and two were with biventricular assist devices (BVAD). The mean ShvO2 values during assistance in each patient ranged from 27 to 84%. One patient with IABP showed persistently low ShvO2 (less than 30%) in spite of higher mixed venous oxygen saturation (SvO2) and subsequently developed hepatic dysfunction and multiple organ failure. In another patient, ShvO2 was 22% on average during LVAD, but increased to greater than 50% after adding a right ventricular assist device (RVAD). Of 3 patients with persistently high ShvO2 (44-80%, on average), only one developed hepatic failure--probably from prior severe shock--and the other two did not develop hepatic failure. There was a significant negative correlation between ShvO2 and splanchnic excess lactate, the parameter of anaerobic metabolism in the splanchnic area. In contrast, there was no correlation between simultaneously measured ShvO2 and SvO2 values when analyzed in a range of SvO2 below 70%. ShvO2 monitoring may be useful for evaluation of hepatic perfusion status in the management of critical patients, requiring assisted circulation.

Heart Failure↗
PubMed1991

[A study of the determination of serum fucose concentrations].

We examined the biochemical properties of reaction products during the procedure for serum fucose determination (Dische & Shettles). The optical density at 396 nm (OD396) of the reaction products increased linearly with the increment of fucose concentrations, and was stable for at least 210-240 min at room temperature. The reaction products were destroyed with the addition of distilled water. Sephadex G-200 gel chromatography of the mixed serum samples revealed a single peak of fucose in the void volume fractions. Of interest was the presence of trace amounts of fucose detected in the low-molecular weight fractions less than 66,000, suggesting the presence of free fucose in the serum. Based on these observations, the method for serum fucose determination was modified so it was possible to use 100 microliters of the serum sample. The mean serum fucose concentration, measured by this modified method, was 561.0 +/- 191.1 mumol/l (9.1 +/- 3.1 mg/dl) in normal healthy children. In patients with idiopathic nephrotic syndrome, the values were significantly higher both at relapse and in remission than those in normal healthy children.

Chemical Fractionation↗
PubMed1991

[Cefepime in the treatment of patients with surgical infections].

Between March 1988 and June 1990, we gave cefepime to 5 subjects after surgery and studied the pharmacokinetics of the drug. In the same period, we treated 23 patients with surgical infections with the same drug and evaluated its clinical efficacy. In the pharmacokinetic study, 1 g was given intravenously to each individual over a 30 minutes period. The peak levels in the plasma, 59.9-118 micrograms/ml, were obtained at around the end of this time. The peak levels in the bile, 7.1-28.2 micrograms/ml, were reached at 1-5 hours after administration, depending on the patient. At hours 5 and 6, the range of plasma concentration was 3.7-12.3 micrograms/ml. In the 22 patients with surgical infections, clinical efficacy of the drug was excellent in 12, good in 5, fair in 1, and poor in 4, with an overall efficacy rate of 77%. The bacteriological response was evaluated in the 16 patients for whom the species of the probable causative organisms were identified. Those bacteria were eradicated in 10 patients, decreased in 3, and were persisted in 3, with an eradication rate of 63%. Against 5 strains of Escherichia coli isolated, the highest MIC was 0.05 micrograms/ml, and against 2 strains of Pseudomonas aeruginosa isolated, the MIC was 1.56 micrograms/ml, so this drug should be highly effective toward these species. Three strains of Staphylococcus aureus were isolated, one of which was resistant to methicillin. It was not eradicated.

Adolescent↗
PubMed1991

[Renal cell carcinoma in a horseshoe kidney].

A 65-year-old man with pyuria visited our hospital. Physical examination had revealed a mass in the left upper quadrant of the abdomen. Intravenous pyelogram, ultrasonogram, computerized tomography and selective renal arteriogram suggested a hypervascular renal cell carcinoma on the left side of the horseshoe kidney. A left radical nephrectomy with division of the isthmus was performed. The pathological diagnosis indicated renal cell carcinoma consisting of clear cell type without invasion of the capsule or renal pelvis. Treatment with alpha-interferon was started and has continued for six months with no evidence of recurrence. Only 35 cases of horseshoe kidney with a renal tumor have been reported in the Japanese literature. Among them, adenocarcinoma was present in 54.3% of the cases, renal pelvic tumor in 17.1%, and nephroblastoma in 14.3%. While adenocarcinoma in horseshoe kidney is seen less often than normal kidney, there is an increased incidence of both renal pelvic tumor and nephroblastoma.

Aged↗
PubMed1991

[Timing of operation based on evaluation of postoperative left ventricular contractility in patients with aortic regurgitation].

To evaluate the effect of aortic valve replacement on left ventricular function in aortic regurgitation, the ratio of end-systolic wall stress to end-systolic volume index (ESS/ESVI) and standard ejection phase indexes of left ventricular function were measured angiographically in 29 patients with isolated, chronic aortic regurgitation before and an average of 26 months after aortic valve replacement. The patients were divided into three groups based on preoperative left ventricular volume at end-systole (ESVI); 12 patients had an ESVI smaller than 100 ml/m2 (group I), 11 had an ESVI of 100 to 200 ml/m2 (group II) and 6 had an ESVI greater than 200 ml/m2 (group III). Postoperatively, end-diastolic volume index and ESVI decreased markedly in all 3 groups and end-systolic stress also decreased. Systolic pump performance assessed as ejection phase indexes improved in all groups with group I and group II showing normal or near-normal ejection fraction, while group III still had a depressed ejection fraction. Left ventricular contractile function as assessed by ESS/ESVI improved significantly in each group postoperatively. After operation, group I patients had normal values. However, both group II and group III still had a subnormal ratio, suggesting a depressed contractility despite normal or near normal systolic pump performance. Surgical correction for aortic regurgitation should be considered before a preoperative ESVI exceeds 100 ml/m2, to preserve postoperative left ventricular contractility.

Adult↗
PubMed1991

[Successful surgical treatment of a case of corrected transposition in situs inversus with associated anomalies].

A 33-year-old female with corrected transposition (situs inversus) with ventricular septal defect (VSD), atrial septal defect (ASD), and pulmonary stenosis (valvular and subvalvular) was operated successfully. Closure of ASD and infracristal VSD was performed through right atrial approach. In order to get complete exposure of VSD, a part of anterior leaflet of mitral valve was detached temporally. An external conduit was interposed between the morphologic left ventricle and the main pulmonary artery to relieve pulmonary stenosis. Postoperative course was uneventful except a transient complete heart block for a day. Several technical aspects of the radical operation were discussed including VSD closure method to avoid damaging the atrioventricular conducting tissues and reconstructive procedure of morphological left ventricular outflow.

Abnormalities, Multiple↗
PubMed1991

Mitochondrial DNA analysis of Leber's hereditary optic neuropathy.

A mitochondrial DNA (mtDNA) mutation associated with Leber's hereditary optic neuropathy (LHON) was recently observed. The presence or absence of the mutation was analyzed in 10 Japanese patients whose clinical course and fundus findings were consistent with LHON. Four of them had at least one maternally related individual who also had bilateral optic atrophy, and were diagnosed as "definite LHON". The other 6 cases lacked any record of optic nerve disease in maternally related individuals, and were diagnosed as "possible LHON". We found the mutation at the SfaNI site of mtDNA in 3 out of the former 4 cases, and in 5 out of the latter 6 cases. This result demonstrates the clinical and diagnostic importance of mtDNA analysis, especially with possible cases of LHON, and suggests that an alternative mutation associated with LHON is also present in Japanese patients.

Adolescent↗
PubMed1991

[Clinical study on fleroxacin in surgical infections].

We conducted clinical studies on fleroxacin (FLRX), a new pyridone carboxylic acid derivative, for the treatment of periproctal abscess, secondary infections (due to wounds, burns or surgical operations), mastitis or areolitis and others with once daily dose of 200 mg or 300 mg. We obtained the following results. Clinical efficacy was evaluated in total 27 cases including periproctal abscess 11, secondary infection 8, mastitis or areolitis 6, phlegmon 1 and infected atheroma 1. Clinical efficacies were rated as excellent in 14, good in 9, fair in 4 cases. The overall efficacy rate was 85.2%. Bacteriological studies identified 14 strains of aerobic Gram-positive organisms, 12 of aerobic Gram-negative organisms and 6 of anaerobic organisms. The overall bacteriological efficacies were: eradicated in 26 strains, unchanged 2 and unidentified 4, hence the eradication rate was 92.9%. As for side effects, anorexia and nausea were observed in one of the 27 cases. In clinical laboratory tests, slight elevations of GPT and BUN were observed in 1 case each. We consider FLRX to be a useful antimicrobial agent at once daily dose for surgical infections.

Abscess↗
PubMed1991

Salivary SPECT and factor analysis in Sjögren's syndrome.

Salivary SPECT and factor analysis in Sjögren's syndrome were performed in 17 patients and 6 volunteers as controls. The ability of SPECT to detect small differences in the level of uptake can be used to separate glands from background even when uptake is reduced as in the patients with Sjögren's syndrome. In control and probable Sjögren's syndrome groups the uptake ratio of the submandibular gland to parotid gland on salivary SPECT (S/P ratio) was less than 1.0. However, in the definite Sjögren's syndrome group, the ratio was more than 1.0. Moreover, the ratio in all patients with sialectasia, which is characteristic of Sjögren's syndrome, was more than 1.0. Salivary factor analysis of normal parotid glands showed slowly increasing patterns of uptake and normal submandibular glands had rapidly increasing patterns of uptake. However, in the definite Sjögren's syndrome group, the factor analysis patterns were altered, with slowly increasing patterns dominating both in the parotid and submandibular glands. These results suggest that the S/P ratio in salivary SPECT and salivary factor analysis provide additional radiologic criteria in diagnosing Sjögren's syndrome.

Adult↗