Biomedical subjects

M Ohta

Publications and source records attributed to M Ohta.

1,437 records · Page 80Linked to original sources

PubMedDate not supplied

Popliteal artery entrapment syndrome. Report of two cases.

We treated two patients with popliteal artery entrapment syndrome. In one, the popliteal artery was entrapped and obstructed in its abnormal course around the medial head of the gastrocnemius muscle, which was inserted into the femur laterally and cephalad (type II in Delaney's classification). In the other patient, the popliteal artery followed a normal course but was compressed laterally by the medial head of the gastrocnemius muscle, which was aberrantly inserted into the femur considerably higher and more lateral than usual, and was occluded. This could not be fitted into Delaney's or Insua's classification. Arterial reconstruction was successful with an autovein graft in the former case and an in situ bypass graft in the latter. We suggest a modification of type IV in Delaney's classification, so that when the popliteal artery is compressed by an aberrant muscular or tendinous structure in the popliteal fossa it can be included.

Adult↗

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Electromyographic responses in leg muscles after electrical stimulation in myelopathy patients with tonic seizures.

The electromyographic (EMG) responses in leg muscles after electrical stimulation of the peripheral nerves were examined in patients with myelopathy. The stimuli were delivered to the tibial nerve at the ankle joint. The EMG responses were recorded from the anterior tibial muscle at the latencies of 80-280 ms. In myelopathy patients with tonic seizures in the extremities, the EMG responses evoked both by single and repeated stimulation were frequently observed. Electrical stimulation also provoked the following tonic seizures in the legs. Stimulation of the back of the big toe or of the sural nerve, also produced the EMG responses in the anterior tibial muscle, and tonic seizure in the leg. There was no difference in the appearance of the EMG responses between patients with and without pain sensation during the seizure. A kind of flexor reflex might be related to tonic seizures in patients with myelopathy, at least in part.

Adult↗

PubMedDate not supplied

Microbiological evaluation of a newly designed dental air-turbine handpiece for anti-cross contaminations.

The effectiveness of a newly developed anti-cross contamination device for a dental air-turbine handpiece was tested. The handpiece with or without the anti-cross contamination device was contaminated with two bacterial strains, Staphylococcus aureus and Streptococcus mutans, as well as two bacteriophage strains, T2 and MS2. After contamination with these microorganisms, the handpieces were disinfected with glutaraldehyde or replaced with newly autoclaved ones. Residual microorganisms inside the handpiece or an air/water supply hose line were collected and counted after overnight cultivation. The anti-cross contamination device effectively reduced the contamination level of an air-turbine handpiece to that of the negative control. No microbial contamination in the air/water supply hose line was detected with this device.

Air Microbiology↗

PubMedDate not supplied

Chemotherapy for advanced non-small cell lung cancer.

Less than 20% of all cases of non-small cell lung cancer are operable. The treatment option available for such patients is either radiotherapy or chemotherapy. Various combinations of chemotherapeutic agents have been tried. The combination of cisplatin and 5-fluorouracil (5-FU) has been proved to have a synergistic antitumour effect in many experimental and clinical studies. In this paper the authors report the results of a trial using tegafur (which is a prodrug of 5-FU; 1-[2-tetrahydrofuryl]-5-FU) and uracil along with cisplatin in inoperable non-small cell lung cancer. Thirty-one patients were entered into the study, all of whom were less than 75 years old (mean age 61 years). The patients (except for 2) had either stage IIIB (12) or stage IV (17) disease with adenocarcinoma and squamous cell carcinoma in equal proportions (15 each). A combination of uracil and tegafur (400 mg/m2) in 100 mg capsules (100 mg tegafur and 224 mg of uracil), was given orally for 21 days. Most of the patients received 300 mg of the combination tablets twice a day. Cisplatin (80 mg/m2) was given as an infusion over 90 minutes on day 8 after adequately hydrating the patients. This cycle was repeated every 4 weeks. At least 2 treatment cycles were given, unless there was disease progression or toxicity. The response and survival rates were assessed after a follow up period which ranged between 9 and 30 months. The patients received 1 to 4 cycles of therapy and the response rates were: complete response--nil,partial response--11, no change--11 and disease progression--9. The overall response rate was 35% (95% CI: range 19-52%). Five patients achieved at least 50% tumour reduction after 2 cycles. Of the 11 patients who showed partial response, 5 (35%) had stage IV disease and 6 (36%) had other stages; 6 (40%) had squamous cell carcinomas and 5 (31%) had tumours of other histological types. The median duration of response was 6 months (3-13 months). In stage III disease, the 1-year survival rate was 31%, with a median survival time of 11 months, while in stage IV disease it was 29% with a median survival time of 8 months. There was a low incidence of toxicity, with anaemia (10%), leukopenia (6%) and thrombocytopenia (6%) being the most common side-effects. There were also no treatment-related deaths. The authors concluded that oral uracil and tegafur were as effective as other combinations with cisplatin. They also caused very few side-effects. They suggest that a larger trial needs to be carried out.

Antineoplastic Combined Chemotherapy Protocols↗

PubMedDate not supplied

Sclerotherapy-resistant esophageal varices with enormously enlarged cephalad collateral vessels predictable using portography.

BACKGROUND/AIMS: The most common cause of failure of sclerotherapy is recurrent bleeding before eradication is complete. We investigated factors which would make feasible prediction of cases where esophageal varices would be more difficult to eradicate. PATIENTS AND METHODS: Seven hundred and seventy patients underwent endoscopic injection sclerotherapy at Kyushu University Hospital from January, 1982 to June, 1989. For 580 of these patients we used the same sclerosant and a transparent overtube. For 19 of 580 patients over two months were needed to eradicate the varices (group 2), while eradication was complete in less than one month in 64 patients (group 1). RESULTS: There was a tendency toward a lower platelet count and a higher indocyanine green retention rate in group 2, but with no statistically significant difference. The number of sessions required for eradication of the varices was 8.1 +/- 2.5 and the total volume of sclerosant used was 98.2 +/- 62.3 ml in group 2, and 3.0 and 47.0 +/- 10.9 ml, respectively, in group 1 (p < 0.01). There was no significant difference in the number of sessions between the patients with large-sized and moderate-sized varices. Based on the extent of cephalad collateral vessels on the venous phase of celiac or superior mesenteric angiography, the vascular pattern could be classified into three types; Grade III, the most developed type was present in 100% and 57.1% on celiac and superior mesenteric angiography in group 2, while the rates were 11.1% and 5.6% in group 1 (p < 0.05). CONCLUSIONS: This retrospective study shows that in patients with enormously enlarged cephalad collateral vessels it may be difficult to eradicate the varices, and in such cases, preoperative portography is most useful to predict whether or not esophageal varices can be eradicated.

Collateral Circulation↗

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The treatment of gastric varices by a balloon-occluded retrograde transvenous obliteration; a transjugular venous approach.

Two Japanese women with a solitary gastric varix were successfully and easily treated by obliterating the gastro-renal shunt with a balloon catheter in a transjugular venous approach without any major complications. The transjugular obliteration was thus found to be a bloodless and useful method for the treatment of a solitary gastric varix with a gastro-renal shunt.

Adult↗

PubMedDate not supplied

Development of early squamous cell carcinoma of the esophagus after endoscopic injection sclerotherapy for esophageal varices.

A 56-year-old Japanese man with liver cirrhosis was admitted to Kyushu University Hospital in September, 1986 for the treatment of large esophageal varices. Endoscopy revealed four tortuous folds of large esophageal varices, extending proximally from the esophagocardial junction to 34 cm from the dental arch. Endoscopic injection sclerotherapy was performed on the lower esophagus using 5% ethanolamine oleate, and esophageal varices were completely eradicated in 5 sessions with a total of 70 ml of sclerosant. In March 1991, 4 years and 6 months after the treatment, endoscopy revealed a mild redness and an irregular surface 33 cm from the dental arch. The histologic diagnosis was squamous cell carcinoma. The possible relationship between sclerotherapy and the development of esophageal carcinoma should be considered.

Carcinoma, Squamous Cell↗

PubMedDate not supplied

Eradication of large gastric varices by sclerotherapy combined with percutaneous transhepatic obliteration.

BACKGROUND/AIMS: The long-term results of a combination therapy of sclerotherapy with percutaneous transhepatic obliteration (PTO) was reviewed in 37 patients with large gastric varices. The study suggests that sclerotherapy combined with PTO can safely and effectively eradicate large gastric varices as an alternative approach to surgery. Complete eradication has also been shown to prevent the recurrence of gastric varices. MATERIAL AND METHODS: The long-term results of a combination therapy of sclerotherapy with PTO was reviewed in 37 patients with large gastric varices. RESULTS: Complete eradication of the gastric varices was obtained in 26 patients (70.3%). There was no recurrence of the varices in whom complete eradication had been obtained, but in 11 patients with incomplete eradication gastric varices recurred during the mean follow-up period of 37.5 months. Bleeding occurred in 4 after the treatment and one patient died of massive bleeding from the recurrent gastric varices. There were no major complications with the procedure except for one who had a peripheral pulmonary arterial embolization as a result of a steel coil used for the PTO. CONCLUSION: This study suggests that sclerotherapy combined with PTO can effectively and safely eradicate large gastric varices and is an alternative approach to surgery for treating patients with gastric varices. It is also shown that complete eradication leads to a prevention of recurrence of gastric varices.

Adult↗

PubMedDate not supplied

Method of noninvasive and continuous hemolysis/thrombogenesis measurement by laser photometry during artificial heart development.

The purpose of this research is to propose and develop a method to measure hemolysis and thrombogenesis non invasively and continuously to aid in development of an artificial heart. Generally, the optical absorption rate of hemoglobin is influenced by oxygen saturation except at the isosbestic point, which is not influenced by oxygen saturation. The authors, therefore, used an 805 nm laser diode, an optical spectrum analyzer to obtain greater accuracy. An experimental blood circuit system was constructed using a Bio-Pump, Tygon tubing, a soft shell reservoir, and an optical measurement system. Experimental settings for monitoring hemolysis were as follows; blood volume 200 ml, blood flow 6 L/min, and afterload 200 mmHg. Blood was sampled six times (0, 30, 60, 120, 180, and 240 min), and hemolysis in each sampled was measured using a colorimetric method. Comparing continuous laser measurement data with the sample data, an adequate correlation is obtained, proving that the dynamic trend of hemolysis could be continuously measured. Furthermore, to analyze the process of thrombogenesis, simple experiments were performed using blood neutralized by protamine. As a result, the authors could see the process of thrombogenesis as it occurred and could confirm that this method is able to dynamically detect hemolysis and thrombogenesis.

Biomedical Engineering↗

PubMedDate not supplied

Detection of plasma (1 --> 3)-beta-D-glucan in patients with Fusarium, Trichosporon, Saccharomyces and Acremonium fungaemias.

(1 --> 3)-beta-D-glucan, a characteristic fungal molecule, is known to increase in blood in invasive candidiasis, aspergillosis and cryptococcosis. This report shows that the plasma glucan concentration was also elevated in four patients infected with Fusarium, Trichosporon beigelii, Saccharomyces cerevisiae and Acremonium. In three of the patients, the elevation preceded positive blood cultures by 5-17 days, and in one of them it even preceded the onset of fever by 6 days. In a fourth patient, the glucan level decreased with clinical improvement. Plasma (1 --> 3)-beta-D-glucan determination appears to be useful also for diagnosis and follow-up of these unusual deep mycoses.

Acremonium↗

PubMedDate not supplied

Laparoscopic repair of a paraesophageal hiatal hernia with gastric volvulus.

We report the case of a massive paraesophageal hiatal hernia with gastric volvulus which presented with the symptom of a precordial sense of pressure for over two years, which was successfully treated with laparoscopic surgery. The patient is presently in good condition, without any recurrence of either the hiatal hernia or other symptoms one year after surgery. This approach is considered to be a safe and effective procedure, and it also provides for rapid recovery from the operation.

Aged↗

PubMedDate not supplied

Jejunal variceal bleeding after esophageal transection in a patient with idiopathic portal hypertension.

This report describes a 38-year-old man with massive gastrointestinal bleeding from jejunal varices. He had been previously diagnosed to have idiopathic portal hypertension and esophageal varices, and had undergone an esophageal transection 8 years earlier. The pre-operative diagnosis was a suspected hemorrhage from the small intestine as visualized by 99mTc-HSAD scintigraphy (technetium 99m-labeled human serum albumin D-type) and was not considered to be repeated massive lower GI tract bleeding. An exploratory laparotomy was performed, and intra-operative endoscopy revealed active bleeding from the jejunal varices. A partial resection of the small intestine resulted in a complete resolution of the bleeding. A review of the literature thereafter disclosed twelve previously reported cases of jejunal variceal bleeding.

Adult↗

PubMedDate not supplied

Laparoscopic splenectomy with the newly devised morcellator.

BACKGROUND/AIMS: One of the major hurdles to overcome in the development of laparoscopic surgery has been finding effective extraction techniques for the removal of large tissue masses. The electromechanical morcellator makes it easy to remove relatively large sections of tissue from the abdomen through the existing incisions. To determine the safety and efficacy of the new morcellator in laparoscopic splenectomy, our preliminary experiences using the morcellator were reviewed and retrospectively compared with the results in patients who previously underwent conventional extraction techniques. METHODOLOGY: From February 1992 to March 1996, 31 patients underwent laparoscopic splenectomy. In the last eight patients, the new morcellator was used to remove the spleen, while in the remaining 23 patients, a laparoscopic splenectomy was performed using the conventional extraction techniques. RESULTS: In the last eight patients who underwent laparoscopic splenectomy, the newly devised morcellator was successfully used without any complications. The spleen could be removed from the abdominal cavity in an average of 15.9 +/- 10.4 minutes using the morcellator, while the average was 45.7 +/- 15.4 minutes using conventional techniques. It was not necessary to extend the skin incision in patients with the morcellator, while, on the other hand, a 2-cm extension of the existing skin incision was always required to remove the spleen in the latter method. CONCLUSION: The morcellator was found to be an effective device which can safely, efficiently and rapidly remove tissue masses. This procedure is therefore considered to be one feasible way to solve the age-old problem of intracorporeal morcellation.

Equipment Design↗

PubMedDate not supplied

Giant gastric varices after a left gastric venous caval shunt operation for esophageal varices: a case report.

A Japanese woman, who had undergone a left gastric venous caval shunt operation for esophageal varices 17 years earlier, was admitted to our hospital because of bleeding from giant gastric varices. An angiographic examination revealed a stealing of the portal blood flow to the inferior vena cava through both a dilated right gastroepiploic vein and a right gastric vein via the left gastric venous caval shunt. The gastric varices disappeared after obliterating both the feeding and drainage vessels by means of intervention radiology. We thus, consider the occlusion of both the afferent and efferent vessels to be an effective treatment for gastric varices.

Adult↗

PubMedDate not supplied

Effects of eicosapentaenoic acids on remnant-like particles, cholesterol concentrations and plasma fatty acid composition in patients with diabetes mellitus.

Remnant lipoproteins are transient metabolites from chylomicron and/or very low density lipoproteins (VLDL), and remnant hyperlipoproteinemia has recently been reported to be a risk factor for atherosclerosis. Eicosapentaenoic acid (EPA), a major component of fish oil, has the following effects: anti-platelet aggregation, vaso-dilation, anti-inflammation, hypotriglyceridemia, and therefore has potential anti-atherosclerotic effects. We measured serum of remnant-like particle cholesterol (RLP-C) concentrations, and investigated the effects of EPA on serum RLP-C concentrations in patients with diabetes mellitus. Ten patients with non-insulin dependent diabetes mellitus were treated with 900-1800 mg EPA ethyl-ester daily for 3 months. We investigated serum RLP-C concentrations and plasma fatty acid composition before and after the administration of EPA. Serum RLP-C concentrations were significantly decreased 3 months after the administration of EPA (from 14.5 +/- 5.3 mg/dL to 3.3 +/- 0.8 mg/dL, P < 0.01). Plasma EPA concentrations and the ratios of EPA to arachidonic acids (AA) were significantly increased during the same period (from 86.2 +/- 12.4 mg/L to 194.6 +/- 27.3 mg/L, P < 0.01, from 0.571 +/- 0.074 to 1.242 +/- 0.163. P < 0.01, respectively). Serum RLP-C concentrations were inversely correlated with the ratios of EPA to AA in plasma (r = -.516, P < 0.05). These results suggested that administration of EPA was effective on remnant hyperlipoproteinemia which was a risk factor for atherosclerosis.

Aged↗