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Biomedical subjects

M Okada

Publications and source records attributed to M Okada.

At least 559 records · Page 31Linked to original sources
PubMed1998

Plasma lipoprotein profiles change significantly during cardiac catheterization.

Most patients in acute myocardial infarction (AMI) undergo emergent coronary angiography (CAG). However, when to analyze lipoprotein profiles in AMI is not clear. To determine whether lipoprotein profiles change during catheterization, we measured serum lipid and apolipoprotein concentrations in 65 patients (51 men and 14 women) before and after catheterization. Heparin was injected at 50 units/kg for CAG and 200 units/kg for percutaneous transluminal coronary angioplasty (PTCA). We found that cholesterol and triglyceride decreased by 9.4% (P < 0.001) and 53.1% (P < 0.001), respectively, after catheterization. Apolipoproteins also decreased significantly. Variables decreased two to five times more after PTCA than after CAG. Lipoprotein lipase mass was higher after PTCA (267.8 +/- 135.3 micrograms/L) than after CAG (93.3 +/- 48.4 micrograms/L; P < 0.05). In conclusion, lipoprotein profiles change during catheterization. We recommend avoiding analysis of lipoprotein profiles after emergent CAG in AMI.

Adult↗
PubMed1998

[Current topics of coronary artery bypass surgery in Japan].

Recently, the number of patients with atherosclerosis has been rapidly increased in Japan. However, there are many kinds of resolving problems for management of those patients. Here history and current topics of coronary artery bypass grafting (CABG) in Japan are clearly documented. That is, CABG could be done in 48,612 cases during the past 5 years (1991-1995). And its mortality rate was 2.3% approximately. On the other hand, 12,025 underwent CABG in 1996 in Japan. Further several kinds of operative methods including MIDCAB have been carried out with the number of the patients with ischemic heart diseases. Excellent results have been obtained respectively.

Coronary Artery Bypass↗
PubMed1998

[Circadian changes in remnant-like particle-cholesterol (RLP-C), and its diagnostic value for postprandial increase in remnant lipoprotein in diabetes mellitus].

To investigate whether remnant-like particle-cholesterol (RLP-C) increases in the postprandial state, and if so, whether such response can be used for detecting postprandial increase in remnant lipoprotein, we measured RLP-C levels at two points (before breakfast, and after lunch), or seven points (before and after each meal, and midnight) in 36 diabetic patients. delta RLP-C was calculated by subtracting RLP-C level before breakfast from that at each point. delta RLP-C after lunch was defined as delta RLP-CL and maximum delta RLP-C as delta RLP-Cmax. Daily profiles of RLP-C (n = 22) showed that RLP-C increased during the daytime in 6 patients (27.3%; responders), but not in the others (nonresponders). In the histogram of delta RLP-Cmax, we could easily distinguish responders (delta RLP-Cmax = 6 approximately 12 mg/dl) from nonresponders (< 4 mg/dl). By using delta RLP-CL of 4 mg/dl as the cut-off value, we could also separate two groups without overlap. With this cut-off value, 11 out of 36 patients (30.6%) were diagnosed as responders. High performance liquid chromatography (HPLC) analysis with cholesterol-monitoring revealed that VLDL-sized RLP increased markedly after lunch in responders. In conclusion, RLP-C increases in some diabetic patients, and delta RLP-CL is useful for detecting postprandial increase in remnant lipoprotein.

Aged↗
PubMed1998

[Combination effect of flutamide and leuprorelin acetate on growth of Dunning R3327-H prostatic adenocarcinoma in rats].

Combined androgen blockade using a pure antiandrogen in association with a LHRH agonist or surgical castration is the most logical approach. This paper demonstrated that flutamide combined with leuprorelin acetate produced a significant reduction in the growth rate of Dunning R3327-H prostatic adenocarcinoma. Dunning R3327-H prostatic adenocarcinoma, provided by Dr. Norman H. Altmann (University of Miami, USA) was subcutaneously inoculated into the lateral region of male Copenhagen x Fischer F1 hybrid rat abdomen. The efficacy of the tumor growth rate was evaluated by measuring tumor size at 10 weeks after the inoculation. Flutamide was orally administered for 10 weeks and leuprorelin acetate was subcutaneously administered every 4 weeks. The effective dose of flutamide and leuprorelin acetate was determined in preliminary studies, and the following doses were used in the study; 15 mg/kg for flutamide, 0.1 mg/kg or 0.4 mg/kg for leuprorelin acetate. In combination of flutamide with leuprorelin acetate at 0.1 mg/kg and 0.4 mg/kg, the tumor inhibition was 94% and 97%, respectively. In addition, the weight of accessory sex organs coincided with the antitumor effect. Taking the above results into consideration, combined androgen blockade using flutamide and leuprorelin acetate may have some beneficial effect on prostatic cancer.

Adenocarcinoma↗
PubMed1998

[Informed consent--on the right of self-determination].

The idea of informed consent asks for the right of self-determination which is very difficult to achieve. Human life does not depend on one's will, and neither does suffering. That is human being does not control one's own life, even though one must be responsible for it. The right of self-determination has long and struggling history. As a result we have acquired the concept of informed consent. And then the physician-patient relationship is no longer considered to be based on paternalism and now the new model is seeked for. All human beings are mortal and cannot inevitably escape suffering. Therefore we must consider the physician-patient relationship as the one based on equality. The problem of self-determination should arise from this understanding.

Freedom↗
PubMed1998

[The measurement of antioxidant activity in human plasma using cumene hydroperoxide].

We describe a new method using cumene hydroperoxide to determine antioxidant activity (AO) in human plasma. We used a kit (Determiner LPO: Kyowa Medex Co., LTD. Tokyo Japan) for the determination of lipid peroxides in plasma or serum. 30 microliters 1 of sample was mixed with 70 microliters 1 of cumene hydroperoxide (50 nmol/ml) and incubated at 30 degrees C for 120 min before analysis. Samples were mixed with 1.0 ml of reagent-I (Determiner LPO) and incubated at 30 degrees C for 5 min. Then 2.0 ml of reagent-II (Determiner LPO) was added and incubated at 30 degrees C for 10 min, at which time the absorbance at 675 nm was measured. AO were calculated using the following formula: AO nmol/ml = 35 nmol/ml-(Es-Eb)/(Estd-Eb) x 35 nmol/ml (Es = sample abs., Eb = blank abs., Estd = standard abs.). Within-run precision for plasma AO was 2.3%. AO in plasma samples stored for 4 h at 4 degrees C was decreased by 1 nmol/ml. After 3 h at room temperature, AO was decreased by the same amount. Because this method measured ascorbic acid, alpha-tocopherol, glutathione peroxidase and quercetin as antioxidant compounds, we were able to measure antioxidant activity in human plasma. Our reference values were calculated from the volunteers group which consisted of 172 students and 82 soldiers. The reference intervals for plasma AO by this procedure were 15.4-20.9 nmol/ml.

Adult↗
PubMed1998

[Ideal production of the magnifying glass for the coronary artery bypass surgery].

In recent year, the number of coronary artery bypass grafting (CABG) has been increased more than 10,000 cases in the year of 1996 in Japan. However, it is very important to use a magnifying glass in CABG, especially for the anastomosis of small-caliber vessels, and to get high patency rate in the long-term. There is no ideal magnifying glass to be available during operation for CABG in the world wide. Therefore, I have produced it with some ideal considerations in the standpoints of from the availability, lightness, and cost performance which will be soon commercially available.

Coronary Artery Bypass↗
PubMed1998

Surgical results of composite graft replacement of the aortic root aneurysm.

From 1986 to 1996, 20 patients underwent aortic root replacement. All of the patients had annulo aortic ectasia (AAE); Six had DeBakey type I aortic dissection, three were acute dissections associated with Marfan's syndrome; three had previously undergone the Koster-Collins operation. During 11 years, the original Bentall procedure (1986-91), the Cabrol procedure (1991-), and the modified Bentall procedure (Carrel patch or Piehler technique) were performed. There was only 1 hospital mortality (5.0%). Four patients died during the follow-up period (mediastinitis, myocardial infarction, cerebral bleeding, and rupture of the arch aneurysm). Only 2 patients required reoperation (repair of a pseudoaneurysm of the right coronary artery and paravalvular leakage of the aortic valve replacement). The satisfactory outcomes were the result of the full-thickness anastomoses performed during coronary artery reconstruction.

Adult↗
PubMed1998

[An aortic valve-sparing procedures (remodeling) for a patient with annuloaortic ectasia: a case report].

A 51-year-old man with annuloaortic ectasia and aortic regurgitation, who did not have Marfan syndrome, underwent an aortic valve-sparing root reconstruction (remodeling). All three sinuses were excised and then the ascending aorta was replaced with a 30 mm collagen-impregnated Dacron graft, one of which ends were scalloped to reproduce pseudosinus. Each coronary artery orifice was anastomosed to the graft with Carrel patch method. Post-operative angiogram showed no aortic regurgitation and no pseudosinus formation, because the graft was slightly larger than the optimal one. The NYHA functional class has been improved III to I 18 months after the operation.

Aorta↗
PubMed1998

[Primary clear cell carcinoma of the lung: report of an operative case].

The patient was a 75-year-old man complaining of cough in July 1996. Chest X-ray demonstrated a tumor in the left S6. Percutaneous lung biopsy specimen revealed lung cancer. On September 4, 1996, left lobectomy (R 2 a) was performed. The tumor was 3.8 x 3.2 x 2.1 cm in size and showed a white yellow solid mass (pT2N0M0, pStage I, p1d0e0pm0). The pathological examination was confirmed no differentiation in adenocarcinoma and squamous cell carcinoma. More than 90% of the tumor cells were characterized as having large clear cytoplasm. On immunohistochemical study, the tumor cells expressed positive with EMA, CEA, cytokeratin and negative with vimentin. The postoperative findings showed no presence of renal cell carcinoma. As the result, a diagnosis of primary clear cell carcinoma of the lung was made. The postoperative course is uneventful.

Adenocarcinoma, Clear Cell↗
PubMed1998

Transmyocardial laser revascularization (TMLR): a long way to the first successful clinical application in the world.

Much attention has been paid to surgical intervention for those patients with small branches or diffuse stenotic lesions of the coronary arteries, for whom coronary artery bypass grafting can not be carried out at all. For resolving these problems, we have planned to supply arterial blood from the left ventricular cavity into the ischemic myocardium through laser channels created by laser into the myocardium. It was obviously recognized that arterial blood could be hemodynamically supplied from the left ventricular cavity into the ischemic myocardium. In trials on dogs, laser channels 0.2 mm in diameter have been shown microscopically to be patent even 3 years after TMLR. Thus, this procedure could be used as a new method of transmyocardial revascularization. Subsequently, TMLR was applied in a 55-year-old male patient with severe angina pectoris who had undergone pericardiectomy 7 years before. He is still alive 12 years after TMLR. This patient was the first successful clinical case treated by TMLR alone, in the world.

Angina Pectoris↗
PubMed1998

A study of the internal structure of the mandibular ramus in Japanese.

To clarify the internal structure of the mandibular ramus in Japanese adults, we performed bone morphometry. Specimens were obtained from four areas: the mid-area between the mandibular foramen and the lowest point of the mandibular notch, areas immediately above and below the mandibular foramen, and the mid-area between the mandibular foramen and the mandibular angle. The mandibular ramus was divided into the anterior and posterior parts, and morphometric analysis was performed on the four areas in each part. The percentage of the trabecular bone area in spongy bone was higher in the anterior part than in the posterior part. In both the anterior and posterior parts, the percentage of trabecular bone was the highest in the most inferior area. Trabecular bone was thicker in the anterior part than in the posterior part. Both in the anterior and posterior parts, trabecular bone was the thickest in the most inferior area. The arrangement of trabecular bone was more complicated in the anterior part than in the posterior part. Trabecular bone was most frequently arranged in the anteroposterior direction. In the superior area of the posterior part, much trabecular bone ran from the posterior buccal side toward the anterior lingual side. Compact bone was thicker in the anterior part than in the posterior part and on the buccal side than on the lingual side. No age-related changes were observed in any element of trabecular bone structure.

Aged↗
PubMed1998

[Treatment of cardiovascular Behçet's disease: a problem with valve replacement].

The treatment of aortic regurgitation (AR) caused by cardiovascular Behçet's disease was retrospectively analyzed in five patients with Behçet's disease complicated by moderate or severe AR (four men and one woman, with a mean age of 47 +/- 5.8 years; complete 1, incomplete 2, and suspected 2). The preoperative left ventricular end-diastolic diameter was larger than 60 mm (mean: 74 mm) in all patients, and the left ventricular fractional shortening was less than 0.28 in three patients. Aortic valve replacement (AVR) was performed in four patients, but perivalvular regurgitation developed in all patients after a mean of 5.4 +/- 1.2 months (range: 0.6-10 months) following surgery, causing the death of three patients. One patient (grade III) who did not undergo operation showed gradually increasing end-diastolic diameter, but he is still being followed up medically due to the poor outcome of surgery. Because of inflammation-induced tissue fragility, AVR was associated with postoperative perivalvular regurgitation and suture breakdown, resulting in an extremely poor outcome. Thus, AVR was considered best avoided even if Behçet's disease was complicated with moderate or severe AR.

Adult↗
PubMed1998

Morphometric study of skin grooves of the head and neck.

The skin surface contains furrows called wrinkles, Langer's lines, and skin grooves that are characteristic ultrastructures of the skin. When a skin incision line is determined, these features should be considered. Many studies have examined skin wrinkles, the number of which increases with age. Langer's lines have also been studied extensively in cadavers. However, these studies may not consistently reflect Langer's lines in living individuals. Most of the studies of skin grooves have examined dermatoglyphics such as fingerprinting, palm printing, and sole printing. Very few studies have examined skin grooves in other areas or quantified their characteristics. The present study analyzed skin grooves of the head and neck in relationship to age, sex, and region. Subjects consisted of 50 nursery school children aged 6 years, 50 college students aged 20 years, and 50 adults aged over 60 years. Impressions were obtained from: 1) forehead, 2) root of the nose, 3) lateral ocular angle, 4) cheek, and 5) neck. The samples were cut into cubes (5.0 x 5.0 x 1.0 mm) and ion-coated with Au-Pdin by a cool sputter coater. Then scanning electron micrographs (x 50) were taken and analyzed by computer morphometry CB-TASPER. Densities of skin grooves and the specific length representing the complexity of grooves per unit area were analyzed using computer morphometry CB-TASPER software. The density of skin grooves differed according to the area, especially among samples taken from the forehead, root of the nose, and the neck. Females had more grooves than males, particularly in the neck region. Skin grooves decreased with age; they appear to change and be absorbed by increasing wrinkles, thus becoming indistinct.

Adult↗
PubMed1998

[The in vitro combination-effect of toremifene with CAF (cyclophosphamide, adriamycin, 5-fluorouracil) on growth of various human mammary carcinomas].

Toremifene (TOR) is a new antiestrogenic agent, a triphenylethylene derivative that was developed as an alternative to tamoxifene (TAM). TOR has been observed to be more effective than TAM with milder toxicity at high doses. We examined the in vitro combination-effect of TOR with cyclophosphamide, adriamycin, 5-fluorouracil and three drug mixture (CAF) on the growth of various human mammary carcinomas. The combination shows a semi-additive or additive growth inhibitory effect on all estrogen positive cells used here except one cell line. In particular, the additive or synergic combination-effect was observed on TAM resistant cells. Furthermore, TOR exhibits a chemosensitizing activity in ADR-resistant cells by expressing P-glycoprotein coded by MDR-1 (multidrug resistance gene). The chemosensitizing activity is dose-dependent of TOR. As described above, the combination of TOR with CAF shows more than a semi-additive effect in this experiment. In conclusion, the addition of high-dose TOR to CAF therapy might be useful for advanced/recurrent breast cancer.

Antineoplastic Agents, Hormonal↗
PubMed1998

Severe corneal dystrophy phenotype caused by homozygous R124H keratoepithelin mutations.

PURPOSE: To determine the mutational status of the beta ig-h3 gene in five patients from four Japanese families affected with an unusual, severe form of corneal dystrophy. In these five cases, the corneas were remarkable for confluent round opacities in the superficial stromal layer. The beta ig-h3 gene coding for keratoepithelin was recently identified as the gene responsible for 5q-linked autosomal dominant corneal dystrophies. METHODS: Genomic DNA was isolated from leukocytes of five patients with the severe form of corneal dystrophy. To screen for point mutations, exons of the beta ig-h3 gene were amplified by polymerase chain reaction and were analyzed with the single-strand conformational polymorphism technique. Subsequently, the mutations were identified by a direct sequencing method and restriction enzyme digestion analysis. RESULTS: All five patients with the severe form of corneal dystrophy had homozygous R124H keratoepithelin mutations. Histopathologic examinations of the corneas obtained from two patients with the severe form showed granular, rod-shaped deposits. CONCLUSIONS: The severe phenotype was a pathologic variant of granular corneal dystrophy (GCD). All five patients had homozygous R124H keratoepithelin mutations. The R124H keratoepithelin mutation is the same mutation recently reported to be responsible for Avellino corneal dystrophy. The homozygous R124H keratoepithelin mutations are the cause of the severe variant of GCD characterized by juvenile-onset and confluent superficial opacity.

Adult↗