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Biomedical subjects

K Ushijima

Publications and source records attributed to K Ushijima.

At least 19 recordsLinked to original sources
PubMed1999

[Unexpected hyperkalemia during general anesthesia in three patients undergoing hepatic, cholangioler or pancreatic surgery].

Three patients developed unaccountable hyperkalemia during general anesthesia for pancreatectomy, hepatectomy, and cholangio-jejunostomy. The patients had normal preoperative renal function, serum potassium values, and intraoperative urine output. The surgical manipulations might have reduced portal venous and/or hepatic arterial blood flow resulting in the hepatic ischemia. Consequently, hepatic intra-cellular potassium might have leaked into the blood causing hyperkalemia. Anesthesiologists should be aware of the potential risk of hyperkalemia caused by surgical interventions on the liver and/or pancreas.

Aged↗
PubMed1998

Histologic characterization of rat ovarian carcinoma induced by intraovarian insertion of a 7,12-dimethylbenz[a]anthracene-coated suture: common epithelial tumors of the ovary in rats?

BACKGROUND: The surface epithelium of the human ovary simulates the mullerian form in tumor formation. In experimental animals, however, such a phenomenon has not previously been observed. METHODS: A chemical carcinogen, 7,12-dimethylbenz[a]anthracene (DMBA), was heated, and the central portion of a 3-0 silk suture was immersed in the melted carcinogen. After vaginal cytology, the DMBA-coated silk was inserted into the ovaries of 40 Wistar strain rats age 7 weeks. The animals were sacrificed when a tumor mass became large enough to extend the abdominal wall. The experimental period lasted for 60 weeks. The tumor histology was compared with that in human counterparts and the mullerian derivatives in rats. RESULTS: In 19 rats, including 4 animals with cornified vaginal smears at the time of DMBA treatment, an ovarian carcinoma developed within 36 weeks. In 17 epithelial tumors, the neoplastic cells proliferated to form papillary or glandular structures, and the lining epithelium consisted of flattened or cuboidal cells and columnar cells, often with pseudostratified nuclei. Adenocarcinoma components transformed into squamous cells in two cases. The remaining two neoplasms were pure mesenchymal tumors with histology of a fibrosarcomatous tumor, and one of them contained heterologous malignant osteoid components. In the remaining 21 rats, including 5 with cornified smears, no tumors developed during the experimental period. CONCLUSIONS: The histologies of DMBA-induced rat ovarian carcinoma simulated the epithelia of rat ovarian surface, fallopian tube, endometrium, and uterine cervix. The results of this study suggest that the surface epithelium of rat ovary also simulates the mullerian form in tumor formation.

9,10-Dimethyl-1,2-benzanthracene↗
PubMed1998

Irinotecan (CPT-11) combined with cisplatin in patients with refractory or recurrent ovarian cancer.

Irinotecan hydrochloride (CPT-11) is reportedly effective for the treatment of refractory or recurrent ovarian cancer. We investigated the antitumor efficacy and toxicity of combination therapy with CPT-11 and cisplatin in 25 patients (mean age 55 years, range 35-73 years) with refractory or recurrent ovarian cancer who had previously undergone platinum-based combination chemotherapy. Patients received two or more courses of treatment consisting of 50 or 60 mg/m2 of CPT-11 on days 1, 8 and 15 and 50 or 60 mg/m2 of cisplatin on day 1 administered intravenously. All patients were evaluable for the response and the toxicity profile. Complete responses were obtained in two (8.0%) patients and partial responses were obtained in eight (32.0%) patients, giving an overall response rate of 40% (10 of 25 patients) (95% CI 23.0-59.0%). The median duration of response was 5.5 months (range 2-27 months), the median time to tumor progression was 6 months (range 3-28 months) and the median overall survival was 12 months (range 3-39+ months). Grade 3 or 4 neutropenia, which was the most frequent and severe toxic effect, occurred in 36 (54.5%) of the 66 treatment courses and in 16 (64.0%) of 25 patients. The nadir of the leukocyte count occurred on days 18-19. Neutropenia was reversed by short-term administration of granulocyte colony-stimulating factor for 2-10 days. Less serious hematologic effects and non-hematologic effects, such as diarrhea, were also observed. This preliminary study showed that this regimen of CPT-11 and cisplatin was effective in patients with recurrent ovarian cancer.

Adult↗
PubMed1998

Characterization of the flanking regions of the S-RNase genes of Japanese pear (Pyrus serotina) and apple (Malus x domestica).

Genomic sequences of the self-incompatibility genes, the S-RNase genes, from two rosaceous species, Japanese pear and apple, were characterized. Genomic Southern blot and sequencing of a 4.5-kb genomic clone showed that the S4-RNase gene of Japanese pear is surrounded by repetitive sequences as in the case of the S-RNase genes of solanaceous species. The flanking regions of the S2- and Sf-RNase genes of apple were also cloned and sequenced. The 5' flanking regions of the three alleles bore no similarity with those of the solanaceous S-RNase genes, although the position and sequence of the putative TATA box were conserved. The putative promoter regions of the Japanese pear S4- and apple Sf-RNase genes shared a stretch of about 200bp with 80% sequence identity. However, this sequence was not present in the S2-RNase gene of apple, and thus it may reflect a close relationship between the S4- and Sf-RNase genes rather than a cis-element important in regulating gene expression. Despite the uniform pattern of expression of the rosaceous S-RNase genes, sequence motifs conserved in the 5' flanking regions of the three alleles were not found, implying that the cis-element controlling pistil specific gene expression also locates at the intragenic region or upstream of the analyzed promoter region.

Amino Acid Sequence↗
PubMed1998

Site-specific cleavage of tRNA by imidazole and/or primary amine groups bound at the 5'-end of oligodeoxyribonucleotides.

Sequence specific RNA cleaving molecules were synthesized by attaching novel polyamine derivatives bearing imidazole and/or primary amine groups to the 5'-end of DNA oligonucleotides as the sequence-recognizing moieties. The actions of the molecules on a half-tRNA(Asp) were investigated. The oligonucleotides directed the nuclease activity (the imidazole and the primary amine are the catalytic groups) of the enzyme to the nucleotides directly adjacent to the complementary target sequence on the substrate RNA. The cleavage reaction shows a bell-shaped pH dependence with a maximum at pH 7.0, indicating the participation of protonated and non-protonated imidazoles residues in the process. The specificity of these hybrid enzymes can be easily altered, and they should prove to be useful tools for probing RNA structures in solution and as potential reactive groups in antisense oligonucleotide derivatives. We also describe the site-specific cleavage of tRNA(Asp) by the cleaving reagents bearing imidazole and/or primary amine groups at the 5'-end of oligodeoxyribonucleotides.

Amines↗
PubMed1998

Cloning and characterization of cDNAs encoding S-RNases from almond (Prunus dulcis): primary structural features and sequence diversity of the S-RNases in Rosaceae.

cDNAs encoding three S-RNases of almond (Prunus dulcis), which belongs to the family Rosaceae, were cloned and sequenced. The comparison of amino acid sequences between the S-RNases of almond and those of other rosaceous species showed that the amino acid sequences of the rosaceous S-RNases are highly divergent, and intra-subfamilial similarities are higher than inter-subfamilial similarities. Twelve amino acid sequences of the rosaceous S-RNases were aligned to characterize their primary structural features. In spite of their high level of diversification, the rosaceous S-RNases were found to have five conserved regions, C1, C2, C3, C5, and RC4 which is Rosaceae-specific conserved region. Many variable sites fall into one region, named RHV. RHV is located at a similar position to that of the hypervariable region a (HVa) of the solanaceous S-RNases, and is assumed to be involved in recognizing S-specificity of pollen. On the other hand, the region corresponding to another solanaceous hypervariable region (HVb) was not variable in the rosaceous S-RNases. In the phylogenetic tree of the T2/S type RNase, the rosaceous S-RNase fall into two subfamily-specific groups (Amygdaloideae and Maloideae). The results of sequence comparisons and phylogenetic analysis imply that the present S-RNases of Rosaceae have diverged again relatively recently, after the divergence of subfamilies.

Amino Acid Sequence↗
PubMed1998

Skin vasomotor reflex as an objective indicator to assess the level of regional anesthesia.

UNLABELLED: We examined whether the absence of a skin vasomotor reflex (SVmR), which represents a sympathetic vasoconstrictive response to various stimuli, is an objective indicator of a somatosensory blockade. Skin blood flow was measured by using a laser Doppler flowmeter on the index finger tip. The somatosensory blockade level was determined in 15 patients under subarachnoid anesthesia. A cold stimulus, an ice cube applied to the skin, was repeated sequentially at each dermatome from L3 cephalad. The uppermost dermatome with negative response (the SVmR cold level) was determined, and the SVmR pain level was determined similarly using an electrical impulse (20-mA, 50-Hz, 0.25-ms square wave). The SVmR cold level and the SVmR pain level showed significant correlation with the conventionally assessed cold level (r = 0.83) and the pinprick level (r = 0.96). We conclude that the SVmR is useful to objectively estimate the level of somatosensory block induced by regional anesthesia. IMPLICATIONS: We evaluated the absence of decrease in skin blood flow after various stimuli as an indicator of somatosensory blockade. In patients under subarachnoid anesthesia, the uppermost level with negative response showed significant correlation with the conventionally assessed blockade level. This method is useful for objective assessment of regional anesthesia level.

Adult↗
PubMed1998

Intestinal absorption of ursodeoxycholic acid in children and adolescents with inflammatory bowel disease.

BACKGROUND: Ursodeoxycholic acid absorption in the proximal intestine may be impaired in patients with inflammatory bowel disease. METHODS: We examined the intestinal absorption of ursodeoxycholic acid by the oral ursodeoxycholic acid tolerance test in 19 children and adolescents with inflammatory bowel disease at various stages, including 8 patients with unoperated Crohn's disease, 3 patients with ileal-resected Crohn's disease, 8 with ulcerative colitis, and 8 healthy control subjects. RESULTS: Ursodeoxycholic acid malabsorption was present in all patients with unoperated Crohn's disease in the first diagnosed active stage, in 3 of 5 patients in a relapsing active stage, and in 2 of 8 patients in remission. Ursodeoxycholic acid absorption was significantly lower in patients in the first diagnosed active stage than in the healthy controls (p < 0.01) or in patients in remission (p < 0.01). There was no significant difference between healthy controls and the patients in a relapsing active stage or in remission. Ursodeoxycholic acid absorption was abnormal during the first postoperative month in patients with ileal-resected Crohn's disease, but normalized over time. Malabsorption of ursodeoxycholic acid was not observed in any patients with ulcerative colitis. CONCLUSIONS: These findings suggest that absorption of ursodeoxycholic acid in the proximal intestine is impaired in patients with Crohn's disease and that the oral ursodeoxycholic acid tolerance test is a convenient and useful means of evaluating the absorption of bile acid in the proximal intestine in pediatric patients with ileal or ileocolic Crohn's disease.

Adolescent↗
PubMed1998

Ovarian endometrioid adenocarcinoma coexistent with benign and borderline endometrioid adenofibroma: a case report.

A well-differentiated endometrioid adenocarcinoma coexistent with benign and borderline-malignant endometrioid adenofibroma was found in the ovary of a 64-year-old woman. She had vaginal bleeding caused by simple hyperplasia of the endometrium due to high levels of sex steroid hormones. A FIGO stage Ia solid ovarian tumor was identified. It was composed of irregularly shaped endometriotic glands with benign and borderline malignant cytologic features embedded in abundant fibromatous stroma. Well-differentiated malignant epithelium was adjacent to these areas, but fibromatous stroma was not predominant. She was treated by surgery and three cycles of chemotherapy. This paper describes this unusual tumor and reviews the literature.

Adenofibroma↗
PubMed1998

[The majority of emergency calls are erroneous].

An emergency call system has been used to summon specialists for cardiopulmonary resuscitation in Kumamoto University Hospital since 1986. Many improvements have been made to the system since it was established. We performed a prospective evaluation of calls made during the period from April 1, 1996 to March 31, 1997. There were a total of 36 calls, but only two of them were judged to be true emergencies. While at first we considered the number of calls reflected a growing awareness of the cardiopulmonary resuscitation team in the hospital, the large number of erroneous calls (94%) indicated other factors needed to be considered. Further investigation revealed the existence of a special, and little-known, telecommunication system connecting various administrative offices of the Japanese Government. Some of the phone numbers in this system are similar to the emergency call number. Thus many of the emergency calls were probably caused by administrative officers who misdialed. We are proposing to change this emergency call number.

Cardiopulmonary Resuscitation↗
PubMed1998

[Sudden ventricular tachyarrhythmia immediately following hepatectomy in a patient with hypomagnesemia].

A 57-year-old male without pre- or intraoperative arrhythmia developed ventricular tachyarrhythmia immediately following hepatectomy. Postoperative examination of plasma electrolytes revealed severe hypomagnesemia (0.16 mmol.l-1). The arrhythmia may have been caused by hypomagnesemia and an imbalance between supply and demand of oxygen in the myocardium, due to hypovolemia and severe anemia from massive hemorrhage. We recommend that measurement of plasma magnesium concentration be included in all perioperative laboratory examinations.

Carcinoma, Hepatocellular↗
PubMed1998

[Altered electrocardiogram during general anesthesia in a patient with intermittent Wolff-Parkinson-White conduction].

A delta wave, which had not been detected in the preoperative electrocardiogram (ECG), was observed just before induction of anesthesia in a 53-year-old male scheduled for partial pancreatectomy. His ECG, diagnosed as intermittent Wolff-Parkinson-White (WPW) conduction, varied markedly displaying different wide QRS complexes with a short PR interval, and then returned abruptly to normal during anesthesia. WPW syndrome belongs to the category of pre-excitation syndromes, which is characterized by the accelerated abnormal conduction to the ventricle and paroxysmal tachyarrhythmias caused by an accessory pathway. We should consider the influence of anesthesia-related agents on atrioventricular conduction, and aim at preventing and managing tachyarrhythmias caused by this syndrome.

Anesthesia, General↗
PubMed1998

[A case of prolonged apnea probably caused by vecuronium potentiated with hypermagnesemia].

A 73-year-old female weighing 41 kg who had undergone ilecolostomy under general anesthesia showed extremely prolonged apnea. Despite only 7 mg of vecuronium, she needed postoperative mechanical ventilation for more than 24 hours. A postoperative examination revealed hypermagnesemia, which probably potentiated the effect of vecuronium. Her hypermagnesemia might be caused by chronic renal failure with hypocalcemia and administration of magnesium sulfate as a cathartic. Plasma magnesium concentration should be measured perioperatively in all surgical cases.

Aged↗
PubMed1998

[Tracheal obstruction caused by bucking during general anesthesia in a patient with a mediastinal tumor].

An eleven-year-old girl underwent an open biopsy of a mediastinal tumor extending from the foreneck to the tracheal carina under general anesthesia. Immediately following the bucking developed at the end of the surgery, she fell into serious ventilatory difficulty. A bronchoscopic examination revealed that the tracheal membrane had protruded into the tracheal lumen by its contraction concurring with the bucking, resulting in the obstruction of the endotracheal tube outlet. Endotracheal anesthesia might accompany tracheal stenosis by bucking, particularly in patients with a tumor surrounding the trachea.

Anesthesia, General↗
PubMed1997

Optimal timing of a second-look operation for advanced epithelial ovarian cancer.

To clarify the optimal timing of second look operation (SLO) for advanced ovarian cancer, we retrospectively reviewed the records of 53 patients with FIGO stage 2, 3 and 4 epithelial ovarian cancer. SLOs were performed more than 12 months after primary surgery in 35 patients (late SLOs), and immediately after first-line chemotherapy in 18 patients (early SLOs). We examined data on SLO findings and patients' clinical courses. SLO findings were positive 5 (27.7%) of 18 in the early SLO group and in 11 (31.4%) of 35 in late SLO group. Positive findings were detected by washing cytology in 3 (60%) of the 5 in the early SLO group compared with 2 (18.2%) of the 11 in the late SLO group. Patients with microscopic disease had better prognosis than patients with macro lesions. False-negative SLO findings were 30.8% in the early SLO group and 12.5% in the late SLO group. All patients who recurred after negative SLOs had grade 2 and 3 tumors. The benefits of SLO were limited to accurate evaluation of first-line chemotherapy and early detection of persistent disease. In these implications, early performance of SLO is recommended.

Adult↗
PubMed1997

[An anesthesia machine malfunction due to dew condensation produced by abnormally high humidity in the electronically-controlled panel].

We present a case of anesthesia machine (NAR-KOMED 2CTM; N2C) malfunction caused by dew condensation. N2C is electronically controlled by an alarm-panel using the remote display. Abnormally high humidity in the operating room made dew condensation in the alarm-panel resulting in an electronic short circuit. Of great importance may be the damp proof improvement on medical equipment including anesthesia machines which have electronic circuits.

Anesthesiology↗