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M Kusunoki

Publications and source records attributed to M Kusunoki.

At least 55 records · Page 3Linked to original sources
PubMed2000

Evaluation of J-pouch reconstruction after total gastrectomy: rho-double tract vs. J-pouch double tract.

OBJECTIVE: Various enteric reservoirs have been advocated to improve the quality of life after total gastrectomy. We evaluated the advantages of pouch reconstruction compared with traditional rho-double tract reconstruction. DESIGN: Prospective randomized study. SETTING: Second Department of Surgery, Hyogo College of Medicine, Japan. SUBJECTS: Forty patients who underwent total gastrectomy for cancer of the stomach were studied. INTERVENTION: Forty patients were randomly divided into two groups: 20 patients received rho-double tract reconstruction (RDT group), and 20 underwent J-pouch double tract reconstruction (PDT group) group. MAIN OUTCOME MEASURES: We compared the body weight, serum nutritional parameters, reflux score, scintigraphic esophageal reflux, food intake, and emptying time of the J-pouch or rho-limb between the two groups. RESULTS: No difference was noted between the two groups with regard to body weight, but food intake tended to be higher in the PDT group than in the RDT group. Total protein and albumin levels were higher in the PDT group than in the RDT group, while scintigraphic reflux was significantly less prominent in the PDT group. CONCLUSIONS: J-pouch reconstruction was superior with respect to protein metabolism, food intake and reduction of reflux esophagitis compared with the traditional RDT method. However, use of pouch reconstruction did not improve postoperative weight gain.

Female↗
PubMed2000

Long-term results of stapled and hand-sewn anastomoses in patients with Crohn's disease.

AIM: This study aimed at determining the reoperation rates of patients with anastomoses for Crohn's disease. The outcome of patients undergoing stapled anastomoses was compared with that of patients having hand-sewn anastomoses. METHODS: Sixty-three patients undergoing intestinal resection for Crohn's disease at our institution from 1987 to 1996 were studied in a prospective, randomized trial. The group undergoing stapling comprised 30 patients and 37 anastomoses. The group with a hand-sewn anastomosis comprised 33 patients and 45 anastomoses. The median follow-up period was 87 (range 36-140) months. RESULTS: There were no significant differences in operative indications or patients' age and sex between the groups. There was a significant difference in cumulative recurrences between the groups (Cox-Mantel test: p = 0.022). CONCLUSION: A stapled anastomosis after resection for Crohn's disease may delay reoperation in patients with symptomatic recurrence.

Adolescent↗
PubMed2000

[Effect of paclitaxel on cisplatin resistant head and neck squamous multicellular tumor spheroids].

Paclitaxel has been reported to be effective for the treatment of CDDP resistant tumors. Thus, the efficacy of paclitaxel on CDDP resistant HEp-2 and KB head and neck squamous carcinoma cell lines was evaluated in monolayer and multicellular tumor spheroids (MTS). Cell lines with a tenfold resistance to CDDP were used in this study (Tanaka, K. et al, Keio J Med, 70. 1993). MTS were developed using the liquid overlay culture technique. After exposure to graded concentrations of drugs and different exposure time, the cells were subjected to a clonogenic assay. The effect of paclitaxel on both monolayer and MTS was dependent on the drug concentration and related to the exposure time. For HEp-2 MTS, 10(-7) M/L of paclitaxel resulted in a cell death rate of approximately 90% in both parent and resistant cells. For KB MTS, the cells were more resistant to paclitaxel than the HEp-2 cells, and a 72 hour exposure time was needed to achieve a cell death rate of approximately 90%. These data suggest that paclitaxel may be effective for treating CDDP resistant head and neck cancer.

Antineoplastic Agents, Phytogenic↗
PubMed2000

[Effects of different types of disparity cues on the response of axis-orientation selective cells in the monkey parietal cortex].

PURPOSE: To specify the cues for the discrimination of orientation in depth in axis orientation selective (AOS) neurons. METHODS: We analyzed the responses of AOS neurons in the monkey caudal intraparietal sulcus (cIPS) region using binocular disparity stimuli generated by stereoscopic 3 D computer graphics. RESULTS: Most AOS neurons (20/27) were sensitive to binocular disparity and showed tuning to the orientation of a slit in the sagittal plane with orientation disparity cues. For 12 neurons we also used an array of discs or dots instead of slits to eliminate orientation disparity. Half of the neurons (6/12) responded better to the slits than to the discs or dots, suggesting that they were sensitive to orientation disparity. Five neurons (5/12) responded equally well to the discs or dots suggesting that they were more sensitive to the gradient of horizontal disparity than to the orientation disparity. CONCLUSION: Both orientation disparity and disparity gradient were likely to be integrated in the cIPS area to represent axis orientation of an object in space.

Animals↗
PubMed1999

Current trends in restorative proctocolectomy: introduction of an ultrasonically activated scalpel.

PURPOSE: We evaluated the usefulness of an ultrasonically activated scalpel (Harmonic Scalpel) for mucosal proctocolectomy and ileal J-pouch-anal anastomosis. METHODS: Seventy-four patients with ulcerative colitis (70 patients) and familial adenomatous polyposis (4 patients) underwent mucosectomy using the Harmonic Scalpel since 1997. We compared the clinical and functional results with those of the monopolar electrocoagulator (forceps coagulation technique, 86 patients with colitis and 7 with polyposis). RESULTS: We performed graduated mucosal proctectomy by using the Harmonic Scalpel. The operative time (Harmonic Scalpel, 42 minutes vs. forceps coagulation technique, 85 minutes) and blood loss (Harmonic Scalpel, 33 ml vs. forceps coagulation technique, 86.8 ml) were significantly reduced by this method. The Harmonic Scalpel enabled restorative proctocolectomy by the synchronous approach within three hours. The functional results and complications were not significantly different between the two groups. CONCLUSION: The Harmonic Scalpel shortened the operative time, decreased blood loss, and was useful for restorative proctocolectomy in our study.

Adult↗
PubMed1999

Transanal mucosectomy using an ultrasonically activated scalpel for ulcerative colitis.

We describe herein our technique of using an ultrasonically activated scalpel (Harmonic Scalpel [HS]) to simplify the procedure of anorectal mucosectomy for ulcerative colitis (UC). This technique was successfully employed to perform restorative proctocolectomy and ileoanal anastomosis (IAA) in ten patients with UC. By using the HS, thermal injury of the internal anal sphincter was avoided during mucosectomy, and we were able to dissect the inflamed mucosa sharply without causing bleeding. HS reduced the operative time and blood loss compared with the traditional forceps-coagulation technique. These results indicate that the introduction of this new scalpel will facilitate an increase in the number of cases of mucosectomy for IAA.

Adolescent↗
PubMed1999

Rat C peptide I and II stimulate glucose utilization in STZ-induced diabetic rats.

AIMS: To study the effects of physiological concentrations of rat proinsulin C peptide I and II, respectively, on whole body glucose utilization in streptozotocin diabetic and healthy rats. METHODS: A sequential insulin clamp procedure was used (insulin infusion rates 3.0 and 30.0 mU.kg-1.min-1) in awake animals. C-peptide infusion rates were 0.05 and 0.5 nmol.kg-1.min-1. Blood glucose was clamped at 7.7 +/- 0.3 mmol/l in the diabetic rats and at 3.9 +/- 0.1 mmol/l in the healthy rats. RESULTS: In diabetic rats infused at lower rates of C peptide and insulin, glucose utilization increased by 79-90% (p < 0.001) compared with diabetic animals infused with saline and insulin. Increasing the rate of C-peptide infusion tenfold did not elicit a statistically significant further increase in glucose utilization. C peptide I and II exerted similar effects. The metabolic clearance rate for glucose in the diabetic animals infused with C peptide was not different from that of the healthy rats. During high-dose insulin infusion (30.0 mU.kg-1.min-1) glucose utilization increased considerably and no statistically significant C-peptide effects were observed. About 85% of the increase in glucose utilization induced by C peptide could be blocked by treatment with N-monomethyl-L-arginine. CONCLUSIONS/INTERPRETATION: Physiological concentrations of homologous C peptide stimulate whole body glucose utilization in diabetic but not in healthy rats. C peptide I and II elicit similar effects. The influence of C peptide on glucose utilization may be mediated by nitric oxide.

Animals↗
PubMed1999

Neural representation of three-dimensional features of manipulation objects with stereopsis.

In the first part of this article, we review our neurophysiological studies of the hand-manipulation-related neurons in the anterior part of the lateral bank of the intraparietal sulcus (area AIP). We describe the properties of visually responsive neurons in area AIP. Object-type visual-dominant neurons responded to the sight of objects and showed selectivity not only for simple geometrical shapes, but also for complex objects such as a knob-in-groove and a plate-in-groove. Some of the object-type visual-dominant neurons showed selectivity for the orientation of the longitudinal axis or the plane (surface) of a plate or a ring. In the second part of this article, we review our study of binocular visual neurons in the caudal part of the lateral bank of the intraparietal sulcus (c-IPS area), in particular, of axis-orientation-selective (AOS) neurons and surface-orientation-selective (SOS) neurons. AOS neurons preferred long and thin stimuli, were sensitive to binocular disparity, and tuned to the axis orientation in three-dimensional (3D) space. SOS neurons preferred broad and flat stimuli and were tuned to the surface orientation in depth. Some SOS neurons responded to a square in a random dot stereogram (RDS) with orientation tuning, suggesting that they encode surface orientation from a disparity gradient. Others responded to solid figure stereograms with orientation disparity and/or width disparity. It was concluded that the c-IPS area is a higher center for stereopsis, which integrates various binocular disparity signals received from the V3 complex and other prestriate areas to represent the neural code for 3D features. It may send projections to the AIP area and contribute to visual adjustment of the shape of the handgrip and/or hand orientation for manipulation and grasping. Neurons of the AIP area may also receive monocular cues of depth from the ventral visual pathway to discriminate the 3D shape of the object of manipulation.

Depth Perception↗
PubMed1999

Crystal structure of beta-amylase from Bacillus cereus var. mycoides at 2.2 A resolution.

The crystal structure of beta-amylase from Bacillus cereus var. mycoides was determined by the multiple isomorphous replacement method. The structure was refined to a final R-factor of 0.186 for 102,807 independent reflections with F/sigma(F) > or = 2.0 at 2.2 A resolution with root-mean-square deviations from ideality in bond lengths, and bond angles of 0.014 A and 3.00 degrees, respectively. The asymmetric unit comprises four molecules exhibiting a dimer-of-dimers structure. The enzyme, however, acts as a monomer in solution. The beta-amylase molecule folds into three domains; the first one is the N-terminal catalytic domain with a (beta/alpha)8 barrel, the second one is the excursion part from the first one, and the third one is the C-terminal domain with two almost anti-parallel beta-sheets. The active site cleft, including two putative catalytic residues (Glu172 and Glu367), is located on the carboxyl side of the central beta-sheet in the (beta/alpha)8 barrel, as in most amylases. The active site structure of the enzyme resembles that of soybean beta-amylase with slight differences. One calcium ion is bound per molecule far from the active site. The C-terminal domain has a fold similar to the raw starch binding domains of cyclodextrin glycosyltransferase and glucoamylase.

Amino Acid Sequence↗
PubMed1999

[Diagnosis of ulcerative colitis and the biopsy method].

The biopsy specimen should be oriented flat on a ground glass slide or on a piece of filter paper so that the submucosa is on the slide and the mucosa uppermost to allow proper histopathological interpretation. It is important to perform the biopsy based on a full knowledge of features of inflammatory diseases of the large intestine. Biopsies should be taken from apparently normal and abnormal mucosa. It is necessary to observe the mucosa of the colon carefully for any mass lesions to find dysplasia or cancer complicating the ulcerative colitis. Any suspicious areas should be liberally biopsied. Biopsies should also be performed at random, because of possible existence of dysplasia or cancer which is not visible at endoscopy. This occurs especially in the rectum; biopsies can also be performed after inversion of the endoscope.

Biopsy↗
PubMed1999

[PMC (pharmacokinetic modulating chemotherapy) for advanced gastric cancer].

We performed pharmacokinetic modulating chemotherapy (PMC) postoperatively in patients with advanced gastric cancer and examined its antitumor and the side effects. Nineteen patients with advanced gastric cancer (all were above Stage II) were treated: 10 had undergone total gastrectomy and 9 distal gastrectomy. UFT (400 mg/day) was orally administered daily and a continuous infusion of 5-FU (600 mg/m2/24 hr) was given once a week. The average observation period was 14.26 months (4-30 months). All patients with Stage II or III disease have survived, but two patients with Stage IV disease died. One patient received insufficient PMC and the other had a liver metastasis. Two patients experienced Grade 3 inappetence, but all other side effects were Grade 2 or lower and the incidence was less than 25%. In conclusion. PMC has tolerable side effects and may be effective in postoperative chemotherapy for advanced gastric cancer.

Administration, Oral↗
PubMed1998

Neural coding of 3D features of objects for hand action in the parietal cortex of the monkey.

In our previous studies of hand manipulation task-related neurons, we found many neurons of the parietal association cortex which responded to the sight of three-dimensional (3D) objects. Most of the task-related neurons in the AIP area (the lateral bank of the anterior intraparietal sulcus) were visually responsive and half of them responded to objects for manipulation. Most of these neurons were selective for the 3D features of the objects. More recently, we have found binocular visual neurons in the lateral bank of the caudal intraparietal sulcus (c-IPS area) that preferentially respond to a luminous bar or place at a particular orientation in space. We studied the responses of axis-orientation selective (AOS) neurons and surface-orientation selective (SOS) neurons in this area with stimuli presented on a 3D computer graphics display. The AOS neurons showed a stronger response to elongated stimuli and showed tuning to the orientation of the longitudinal axis. Many of them preferred a tilted stimulus in depth and appeared to be sensitive to orientation disparity and/or width disparity. The SOS neurons showed a stronger response to a flat than to an elongated stimulus and showed tuning to the 3D orientation of the surface. Their responses increased with the width or length of the stimulus. A considerable number of SOS neurons responded to a square in a random dot stereogram and were tuned to orientation in depth, suggesting their sensitivity to the gradient of disparity. We also found several SOS neurons that responded to a square with tilted or slanted contours, suggesting their sensitivity to orientation disparity and/or width disparity. Area c-IPS is likely to send visual signals of the 3D features of an object to area AIP for the visual guidance of hand actions.

Animals↗
PubMed1998

Simulation of S2-state multiline EPR signal in oriented photosystem II membranes: structural implications for the manganese cluster in an oxygen-evolving complex.

High-quality angular-dependent spectra of multiline electron paramagnetic resonance (EPR) signals from the S2-state Mn cluster in a photosynthetic oxygen-evolving complex (OEC) were obtained for partially oriented photosystem (PS) II membranes, and the magnetic structure of the Mn cluster has been studied by simulation analysis. The angular-dependent multiline spectra were simulated by taking into account the anisotropic properties of both hyperfine tensors of intrinsic Mn ions and g-tensor of the cluster in a tetranuclear model. The best-fit parameters for the simulation indicate that (a) the oxidation state of the S2-state Mn cluster is Mn(III, IV, IV, IV), (b) the electronic orbital configuration of the Mn(III) ion is (dpi)3[dz2(sigma))]1, (c) the effective g-tensor of the Mn cluster and the hyperfine tensor of the Mn(III) ion are axially symmetric, and their principal z-axes are nearly collinear each other, and (d) the z-axis of the dz2 orbital of the Mn(III) ion and the normal of the thylakoid membrane are at an angle of 50.1 +/- 1.8 degrees. The results are compatible with those of the oriented XAFS study [Mukerji, I., et al. (1994) Biochemistry 33, 9712-9721], and indicate that the O-O vector of the putative di-mu-oxo bridged Mn(III)-Mn(IV) dimer unit in the Mn cluster tilts by 43-56 degrees with respect to the normal of thylakoid membrane. A model of the arrangement of the di-mu-oxo bridged Mn(III)-Mn(IV) unit with respect to the thylakoid membrane is proposed.

Absorptiometry, Photon↗
PubMed1998

A lipoprotein lipase activator, NO-1886, improves endothelium-dependent relaxation of rat aorta associated with aging.

Endothelial function is closely related to development of atherosclerosis and is impaired with aging. The novel compound NO-1886, 4-diethoxyphosphorylmethyl-N-(4-bromo-2-cyanophenyl)benzamid e, is a lipoprotein lipase activator and its long term administration protects against the development of experimental atherosclerosis in animals. The aim of this study was to ascertain whether NO-1886 ameliorates the impaired endothelium-dependent relaxation of rat aorta associated with aging. NO-1886 (50 mg/kg p.o.) was administered to 7-month old rats for 3 months. Plasma lipid, glucose and insulin levels in old control rats (10 months of age) were significantly higher than those of young rats (2 months of age). NO- 1886 decreased plasma triglyceride levels (old rats, 233+/-10 mg/dl; old rats + NO-1886, 172+/-16 mg/dl, P < 0.01) and increased plasma high density lipoprotein (HDL) cholesterol level (old rats, 72+/-6 mg/dl; old rats + NO-1886, 142+/-6 mg/dl, P < 0.001) in old rats, but had no effects on plasma glucose or insulin. The endothelium-dependent relaxation of the thoracic aorta caused by histamine was significantly impaired in old rats (% relaxation at 10(-5.5) M histamine: young rats 25.4+/-3.1%; old rats 14.1+/-1.9%, P < 0.01), an effect completely prevented by NO-1886 (old rats + NO-1886; 22.8+/-2.8%, P < 0.05 vs. old rats). In contrast, NO-1886 showed no effect on the endothelium-independent relaxation by sodium nitroprusside. These results indicate that NO-1886 improves impaired endothelium-dependent relaxation of rat aorta associated with aging, possibly by correcting lipid metabolism.

Aging↗
PubMed1998

The representation of visual salience in monkey parietal cortex.

When natural scenes are viewed, a multitude of objects that are stable in their environments are brought in and out of view by eye movements. The posterior parietal cortex is crucial for the analysis of space, visual attention and movement. Neurons in one of its subdivisions, the lateral intraparietal area (LIP), have visual responses to stimuli appearing abruptly at particular retinal locations (their receptive fields). We have tested the responses of LIP neurons to stimuli that entered their receptive field by saccades. Neurons had little or no response to stimuli brought into their receptive field by saccades, unless the stimuli were behaviourally significant. We established behavioural significance in two ways: either by making a stable stimulus task-relevant, or by taking advantage of the attentional attraction of an abruptly appearing stimulus. Our results show that under ordinary circumstances the entire visual world is only weakly represented in LIP. The visual representation in LIP is sparse, with only the most salient or behaviourally relevant objects being strongly represented.

Animals↗
PubMed1998

Usefulness of bipolar scissors for total colectomy.

PURPOSE: Total colectomy is frequently used in colorectal surgery. We evaluated the usefulness of bipolar scissors in this operation. METHODS: Twenty patients with ulcerative colitis underwent total colectomy at Hyogo College Hospital. Bipolar scissors were used in ten randomly chosen colectomies. The resected major vessels of the colonic mesentery were stained by hematoxylin and eosin. The bursting pressure of the artery weld was measured with a water-filled, open-tip catheter. RESULTS: Both number of ligations and operating time were reduced by use of bipolar scissors. The cut edge of the major artery was occluded by the weld created, with a mean bursting pressure of 213 (range, 175-250) mmHg. CONCLUSION: Use of bipolar scissors was safe and had the advantage of shortening the operating time by decreasing the number of clamping and ligating procedures.

Adolescent↗