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Biomedical subjects

K Sakai

Publications and source records attributed to K Sakai.

At least 991 records · Page 55Linked to original sources
PubMed1989

[Determination of urinary NAG isozyme by thermal inactivation and the age difference].

We studied isozymes of urinary beta-D-N-acetylglucosaminidase (NAG), NAG-A and NAG-B, to develop a method for the determination of them. Urinary NAG-A was demonstrated to be measured most appropriately by the thermal inactivation at 50 degrees C for 4 hours in the buffer solution of pH 4.8. Using this method, 13 subjects were simultaneously measured for the levels of both urinary and serum NAG-A, which revealed no significant relation between them (r = 0.03). A significant increase in the mean value of urinary NAG-A activities (U/ml) was found in the 11-12 year-old subjects compared with those in the 6-7 year-old subjects. Although no significant differences were revealed among the total urinary NAG activities of the subjects, the values of NAG-A/total NAG (percent) tended to increase as the ages of the subjects increasing. In conclusion, when determining urinary NAG levels, a careful consideration must be taken into account for the presence of heterozygous carriers for Tay-Sachs disease who have a 50%-deficiency of NAG-A activity and for the age difference of the values.

Acetylglucosaminidase↗
PubMed1989

[Strengthening for dental porcelain surface].

UNLABELLED: Although the metal crown is aesthetically improved when porcelain is fused to it, a large number of different factors often cause the porcelain to break. Here we report a method to prevent this from happening. As a hardening treatment for the porcelain surface, the Na-ions in the porcelain, which have a short radius, were replaced by K-ions having a long radius to strength the surface against compressive forces. RESULTS: 1. The bending test showed that the strength of the porcelain had increased from 20 to 38%. 2. The hardness test indicated that the strength had increased from 23 to 24%. 3. The breaking test showed that although the strength of the porcelain had not increased to any great extent, the strength of the veneer shell had increase by more than 30%. 4. The EPMA measurement showed that ion replacement had penetrated to as much as 50 to 80 microns. 5. Clinical tests indicate that even after 19 months, the surface of the porcelain remains the same and that the condition is quite stable.

Dental Porcelain↗
PubMed1989

[Left ventricular contractile function and prognosis of surgical treatment in patients with chronic mitral regurgitation].

We assessed the preoperative left ventricular contractile function affected to the postoperative prognosis in 28 patients with chronic mitral regurgitation (MR). The patients were divided into two groups and compared with 11 normal subjects. 21 patients improved clinically after surgery (group-A) and 7 patients died or did not improve with surgery (group-B). Both preoperative end-diastolic volume index (EDVI) and end-systolic volume index (ESVI) were significantly greater in group-B than in group-A (220 +/- 48 vs 162 +/- 48 ml/M2, 143 +/- 50 vs 66 +/- 21 ml/M2, p less than 0.01). Ejection fraction (EF) was lower in group-B than in group-A (0.36 +/- 0.07 vs 0.59 +/- 0.08, p less than 0.01). End-systolic stress (ESS) was higher in group-B than in group-A (250 +/- 38 vs 170 +/- 37 kdyne/cm2, p less than 0.01). ESS/ESVI was lower in group-B than in group-A (1.83 +/- 0.28 vs 2.66 +/- 0.68 kdyne.M2/cm5, p less than 0.01). The ratio of wall thickness to radius at end-systole (h/R) was higher in group-A than in group-B (0.32 +/- 0.13 VS 0.18 +/- 0.05, p less than 0.01). There were significant positive correlation between ESS and ESVI in normal subjects (Y = 2.14X + 78, r = 0.59, p less than 0.05) and in MR (Y = 210 logX - 206, r = 0.81, p less than 0.001). Patients in group-B were distributed rightward on the logarithmic correlation curve in MR. These data indicated more depressed contractility in group-B than group-A.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

[Clinical evaluation of Parkinson's disease using 123I-IMP SPECT].

N-isopropyl-p[123I]iodoamphetamine (123I-IMP) SPECT and regional cerebral blood flow (rCBF) studies were performed in 20 patients with Parkinson's disease (PD) and 8 normal subjects. RCBF was measured by the arterial blood sampling method which used the microsphere model. We analyzed seven factors which might be related to the rCBF in PD, i.e., age, stage, duration of the disease, cerebral atrophy, severity of dementia, laterality of symptoms and motor disability score (MDS; the degree of akinesia, rigidity, tremor, gait disturbance, freezing and pulsion sign). Compared with normal subjects, global CBF (supratentorial mean rCBF) was reduced 21.8% in PD. In particular, rCBF in the basal ganglia and that of frontal cortex were reduced 25.3%, 24.8%, respectively. Distribution patterns of rCBF in PD were almost as same as those in normals except for cerebellum. The reduction of both rCBFs in the basal ganglia and parietal cortex significantly correlated with MDS (p less than 0.05, respectively). Especially, akinesia was closely correlated to the reduction of rCBF in the parietal cortex (p less than 0.02). Moreover, we observed a significant relationship between cerebral atrophy and reduction of rCBF in each region except for cerebellum. However, there was no significant correlation between the severity of dementia and reduction of rCBF, even in the frontal cortex or parietal cortex. These data show that the severity of dementia in PD may be connected with other factors except for rCBF. 123I-IMP SPECT study is a useful method for clinical evaluation of PD.

Aged↗
PubMed1989

[Bilateral internal mammary artery grafting for a patient with poor left ventricular function].

The patient was a 49-year-old man with triple vessel disease. He had been suffered from inferior and antero-septal myocardial infarctions. His left ventricular ejection fraction was estimated as 17 percents. An exercise thallium myocardial scan revealed the area of septal and inferior reversible ischemia. Bilateral in situ internal mammary artery grafting was done; the left internal mammary artery was anastomosed to the left anterior descending coronary artery and right internal mammary artery to the right coronary artery. Assisted circulation with IABP was required after operation. Post operative course was uneventful, and clinical state was improved.

Coronary Disease↗
PubMed1989

[Prostaglandin E1, as a vasodilator therapy, for low output syndrome after cardiac surgery].

Prostaglandin E1 (PGE1) has a direct vasodilating effect to smooth muscles of resistant vessel much more than that of capacitance one. In afterload mismatch, vasodilator which acts on resistant vessel mainly should be selected. We used PGE1 for vasodilator therapy to two patients with low cardiac output syndrome (LOS) in intensive care unit. One patient undergoing coronary artery bypass grafting developed LOS and disseminated intravascular coagulation which derived from post-transfusional anaphylactoid reaction. Another patient undergoing mitral valve replacement, tricuspid valve annuloplasty and coronary artery bypass grafting also developed LOS with massive thrombosis caused by cold agglutinin during cardio-pulmonary bypass. In both patients, PGE1 decreased systemic vascular resistance index and pulmonary arterial resistance index, and increased cardiac output. PGE1 inhibits release of lysosomal enzymes from polymorphonuclear leukocytes and increases splanchnic blood flow. These effects lead to inhibit production of myocardial depressant factor and might relate to the improvement of LOS partially. We suggest that PGE1 was effective for LOS after cardiac surgery, especially in afterload mismatch.

Aged↗
PubMed1989

[The value and limitation of two-dimensional transesophageal echocardiography in diagnosis of dissecting aortic aneurysm].

The diagnostic value of two-dimensional transesophageal echocardiography (TEE) was evaluated in 29 patients with dissecting aortic aneurysm (DeBakey type I; 4, type II; 1, type IIIa; 6, type IIIb; 18) who were studied consecutively from May 1987 to August 1988. An intimal flap was demonstrated in all 29 cases. DeBakey type classification could be recognized in 26 of 29 patients (89.7%). The entry of aortic dissection could be identified in 26 of 29 patients (89.7%). The differentiation between true and false lumen could be performed in all 29 cases. The introduction of color Doppler and pulsed Doppler echocardiography has opened up an additional possibility, in particular an analysis of flow pattern of the lumen was valuable in differentiation between true and false lumen. TEE was also valuable in evaluation of operative procedure by means of intraoperative-TEE. The capability to visualize the lesion of descending aorta was superior to any other conventional diagnostic method such as CT, MRI, AOG. However, there were difficulties in scanning the distal part of the ascending aorta and aortic arch, and in identifying the reentry of arotic dissection except for DeBakey type IIIa dissection. Since transthoracic echocardiography was valuable in diagnosis of cardiac tamponade, aortic regurgitation, and DeBakey type I dissection, the diagnostic method of a combination of transthoracic and transesophageal echocardiography seems to be more valuable.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

Amino acid sequence of ferredoxin isolated from Cyanidium caldarium strain RK-1.

Ferredoxin was isolated from ther eukaryotic alga Cyanidium caldarium strain RK-1 and its amino acid sequence was determined. The ferredoxin is composed of 97 amino acid residues, and its molecular weight is 10,599 excluding the iron-sulfur cluster. The amino acid sequence differs from that of C. caldarium strain 1355/1, by 24 amino acid substitutions plus one deletion at the amino terminus.

Amino Acid Sequence↗
PubMed1989

[Epithelial dysplasia and invasive carcinoma of oral cavity showing punctation and atypical vessels].

We have experienced epithelial dysplasia and invasive carcinoma of oral cavity, showing punctation and mosaic like atypical vessels confirmed by usual photographing. Case 1: 42-year-old man. After resection of tongue leukoplakia, the punctation appeared in the distal region of resected wound. Pathological findings were epithelial dysplasia, and expansion of capillaries in the stromal papillae were close to the surface. Case 2: 55-year-old woman. Punctation and mosaic like atypical vessels were recognized in the buccal mucosa, extending from the gingival carcinoma. Pathological findings were epithelial dysplasia and carcinoma in situ in punctation, and early invasive carcinoma in mosaic. There were irregularly expanded capillaries in the stromal papillae being close to the surface at both mosaic and punctation area. Although punctation, atypical vessels and mosaic are the colposcopic findings of uterine cervical cancer, these findings may become diagnostic point of early oral cancer.

Adult↗
PubMed1989

[Surgical treatment of the thoracoabdominal aortic aneurysms with Marfan's syndrome].

We experienced two cases of the thoracoabdominal aortic aneurysms with Marfan's syndrome. Case 1; The 31 year-old-woman was operated upon by Crawford's procedure, which includes reconstruction of renal arteries, superior mesenteric artery, and celiac artery using temporary shunt. Although she had been well for three years after the operation before she developed acute aortic dissection, she could not tolerate the Bentall's procedure on it. Case 2; The 37 year-old woman was operated upon for dissecting aneurysm (DeBakey IIIb). The procedure included replacement of the descending and abdominal aorta by Dacron graft. Four years after the operation, enlargement of residual false lumen had been observed, which caused its dehiscence just proximal to the abdominal aortic anastomosis. The Crawford's procedure, which includes reconstruction of renal arteries, superior mesenteric artery, and celiac artery using temporary shunt was employed for repair of the remaining thoracoabdominal aortic aneurysm. She is well now 5 months after surgery. We conclude that cardiovascular changes in patients with Marfan's syndrome must be observed carefully because of its high recurrent rate after initial surgery. The operation at proper time and a careful observation of cardiovascular changes will improve the prognosis.

Adult↗
PubMed1989

[Comparative analysis of mechanical and biological prosthetic valves after isolated valve replacement--cooperative study on total 1281 patients].

A total of 1281 patients (594 aortic and 687 mitral) received 734 mechanical valves (320 Björk-Shiley, 283 SJM and 131 Omniscience) and 547 biological (259 ionescu-Shiley, 227 Hancock, and 61 Carpentier-Edwards) were analyzed for postoperative valve dysfunction and thromboembolism. The actuarial survival rates (free from late cardiac deaths and valve-related deaths) were 88.6% (11 years) for mechanical mitral and 86.0% (11 years) for biological mitral valves, and 91.7% (16 years) and 88.5% (12 years), for mechanical and biological aortic valves, respectively. There were no significant differences among these groups. Actuarial rates of freedom from valve-related events were 88.7% (11 years) and 51.7%, for mechanical and biological mitral valves, respectively. There was significant difference between the two types of valves in over 7 years after surgery. In contrast, there were no significant differences between mechanical and biological aortic valves. Actuarial rates of freedom from valve dysfunction were 97.6% (11 years) for mechanical and 56.5% (12 years) for biological mitral valves. The net 12 year results showed no significant differences between the two types of mitral prosthetic valves, but a significantly increased rate of valve dysfunction in the biological mitral valves compared with the mechanical in over 6 years of the study. Concerning AVR, there were no significant differences in the incidence of valve dysfunction between mechanical and biological aortic valves. Actuarial rates of freedom thromboembolism were 92.3% (11 years) and 93.8% (11 years) for mechanical and biological mitral valves, respectively. There were no significant differences between the two types of mitral prosthetic valves.(ABSTRACT TRUNCATED AT 250 WORDS)

Aortic Valve↗
PubMed1989

[Two-chambered right ventricle in an elderly patient with anoxic spells].

A 53-year-old woman with two-chambered right ventricle and ventricular septal defect (VSD) was treated by VSD closure and resection of the abnormal muscle bundle within the right ventricle. The patient remained asymptomatic only with a heart murmur until the age of 40. Then she became to get tired more easily and presented dyspnea on minimal exercise. And recently, she suffered from cyanosis with anoxic spells, which finally led her to our clinic. Cardiac catheterization showed a high pressure chamber of 110 mmHg and a low pressure chamber of 27 mmHg in the right ventricle; a pressure gradient being 83 mmHg in the right ventricle with bidirectional interventricular shunt. This disorder is rarely found in elderly patients and the natural history for patients who remain asymptomatic are still unknown. To the best of our knowledge, this is the first elderly patient to develop anoxic spells like tetralogy of Fallot and treated surgically. The case is presented here, together with a review of the literature.

Female↗
PubMed1989

[The use of PGE1 in an elderly patient with mitral valve regurgitation during general anesthesia].

PGE1 has a beneficial effect on cardiac failure with mitral valve regurgitation by decreasing the "after load". An 82-year-old female had a total cystectomy of a bladder tumor. The preoperative standard 12 lead electrocardiogram showed atrial fibrillation and incomplete right bundle branch block. The preoperative echocardiogram showed regurgitation of both mitral valve and tricuspid valve. Under heavy premedication, we intubated with fentanyl and pancuronium bromide, maintained anesthesia with enflurane. After incision, both pulmonary artery pressure and pulmonary capillary wedge pressure increased, and cardiac index decreased. Continuous injection of 100ng.kg-1.min-1 PGE1 made pulmonary artery pressure and pulmonary capillary wedge pressure to decrease, and cardiac index to increase. PaO2, however, decreased apparently. PGE1 was effective for cardiac failure with mitral valve regurgitation associated with pulmonary hypertension. But attention must be given to the decrease in PaO2.

Aged↗
PubMed1989

[Afterload reduction therapy with prostaglandin E1 (PGE1)].

Increases in afterload cause marked decreases in cardiac output and left ventricular stroke volume in patients with congestive heart failure. We studied the effects of afterload reduction therapy with prostaglandin E1 in three patients with intraoperative heart failure and two patients with low output syndrome after coronary artery bypass grafting. After 120 minutes, mean pulmonary arterial pressure decreased from 25.6 to 17.4 mmHg, pulmonary wedge pressure from 20.0 to 10.2 mmHg and right atrial pressure from 10.2 to 6.8 mmHg. Cardiac index increased from 1.73 to 2.80 l.min-1.m-2. The improvement of peripheral circulatory failure was remarkable and all patients recovered from heart failure. This study suggests that PGE1 is effective for afterload reduction therapy.

Aged↗
PubMed1989

[Anesthetic management of spinal progressive muscle atrophy (SPMA)].

The patient with spinal progressive muscle atrophy (SPMA) has many anesthetic problems; muscle atrophy, respiratory complications, hypersensitivity to non-depolarizing muscle relaxants and succinylcholine-induced hyperkalemia. Although neurological complications following spinal and epidural anesthesia have been reported in various neurologic diseases, we chose epidural anesthesia for the patient with SPMA and experienced no problems during and after the operation. We conclude that epidural anesthesia is a useful technique for the patient with SPMA.

Adult↗
PubMed1989

[Anesthetic management of thrombotic thrombocytopenic purpura].

A 46-year-old man, with TTP and renal failure, received splenectomy because complete remission was not achieved after the treatments such as plasma exchange, antiplatelet agents and corticosteroid. After the administration of methylprednisolone, anesthesia was induced with thiamylal and succinylcholine chloride and maintained with nitrous oxide, enflurane, fentanyl and vecuronium. Total blood loss was 1710 gram. Four units of packed red cell and 9 units of fresh frozen plasma were infused. The anesthetic course was uneventful. TTP is a rare and usually fatal disease and its etiology is unknown. Careless infusion of platelet or fresh blood may accelerate the disease process and multiorgan dysfunction may present other anesthetic problems. In this report, problems of anesthetic management for TTP were discussed.

Anesthesia, Inhalation↗