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Biomedical subjects

M Okada

Publications and source records attributed to M Okada.

At least 649 records · Page 36Linked to original sources
PubMed1997

[Surgical treatment of primary pulmonary malignant lymphoma: a report of successful case].

A 73-year-old male was admitted to our hospital because of abnormal shadow in the lung field. The pathological report of the percutaneous needle lung biopsy specimen under the CT scan was suggested lymphoma (lymphomatoid granulomatosis suspected), and the right middle lobectomy was performed. Histological and immunohistochemical examinations of the operative specimen revealed B-cell type malignant lymphoma (diffuse pleomorphic lymphoma, large cell type, high grade lymphoma). Primary pulmonary malignant lymphoma is a rare disorder, and it is difficult utilized to distinguish between true malignant lymphoma and lymphomatoid granulomatosis, or pseudolymphoma. Anyway, the first choice of the treatment is surgical excision, because of its satisfactory prognosis.

Aged↗
PubMed1997

[A case report: surgical treatment of hypertrophic obstructive cardiomyopathy with acute hemodynamic deterioration due to chordae rupture of the mitral valve].

A 70-year-old woman was found to have new heart systolic murmur and was transferred to our hospital for the treatment of high fever and dyspnea. The chest X ray showed cardiomegaly (CTR 63%) and marked pulmonary congestion. The UCG revealed that there was no evidence of infective endocarditis, but there was hypertrophic obstructive cardiomyopathy with the left ventricular pressure gradient of 90 mmHg accompanied by mitral regurgitation (grade 3/4). Two weeks after the admission, mitral regurgitation progressed due to chordae rupture confirmed by UCG. Transaortic subvalvular myectomy and mitral valve replacement were underwent. Post-operative electrocardiogram demonstrated right and left anterior bandle branch block. Eleven months after the operation left ventricular outflow pressure gradient was not detected by echocardiogram and she has been in I/IV NYHA functional class.

Aged↗
PubMed1997

[Successful surgical treatment for giant non-specific cyst in the anterior mediastinum].

A 46-year-old woman was admitted to our hospital with giant cyst in the anterior mediastinum. We strongly suspected the cyst would be cystic teratoma from preoperative examinations. Cystectomy was undergone through a right thoracotomy in the 6th intercostal space. The cyst, 15 x 14 x 13 cm in size, had a fibrous wall and contained yellowish serous fluid with hair-ball which revealed aseptic bacteriologically. In the pathological study, the cyst had no recognizable specific epithelium or mesothelium, and this finding was incompatible with cystic teratoma. Due to lack of teratoid elements, the final diagnosis was "non-specific mediastinal cyst". The cyst was considered to be the result of inflammation or intracystic auto-digestion by enzymes from the alimentary tissue of the cystic teratoma.

Diagnosis, Differential↗
PubMed1997

[Familial Creutzfeldt-Jakob disease with the heterozygous point mutation at codon 200 of the prion protein gene (Glu-->Lys)--report of CJD200 brothers of Yamanashi Prefecture origin].

We report two brothers with familial Creutzfeldt Jakob disease (CJD) having a heterozygous point mutation at codon 200 of the prion protein gene (Glu-->Lys): CJD200. The brothers were born in Kitakoma-gun, Yamanashi Prefecture. Patient 1, a 62-year-old man, developed CJD in 1995 and died nine months later. Patient 2, his brother, developed CJD200 at the age of 58 in 1982 and died 13 months later. They both exhibited rapidly progressive dementia with myoclonus and periodic synchronous discharges on electroencephalograms and became bedridden with three or four months. DNA analysis of peripheral blood cells of patient I showed a point mutation in the prion protein gene at codon 200: GAG-->AAG (Glu-->Lys). Five families with CJD200, 11 patients, have been reported in Japan to date, and nine of the patients from four families were born in Yamanashi Prefecture and vicinity. Our patients were born in the same area. We suspect that there is a cluster of CJD200 in Yamanashi Prefecture and vicinity. In Europe and America the phenotype of CJD200 has been reported to be heterogeneous, whereas the clinical features in Japanese cases are fairly homogeneous. We suspect that these patients have a common ancestor with a codon 200 mutation, and that that explains why the phenotypes are homogeneous.

Creutzfeldt-Jakob Syndrome↗
PubMed1997

Single lung transplantation for canine pulmonary hypertension.

BACKGROUND: In spite of recent reports of the clinical application of single lung transplantation for pulmonary hypertension, there is little underlying experimental data because of the lack of a reliable animal pulmonary hypertensive transplant model. We have established a pulmonary hypertensive model in beagles with dehydromonocrotaline and have been able to measure cardiopulmonary hemodynamics accurately and use circulatory assists during procedures. The purpose of this study was to determine whether single lung transplantation could be performed after the protocol of clinical procedure. METHODS AND RESULTS: In six control dogs, allografting was successfully completed without cardiopulmonary bypass. Because one pulmonary hypertensive recipient dog died of right ventricular failure during the procedure without cardiopulmonary bypass, we used bypass for allografting in five pulmonary hypertensive dogs. Cardiopulmonary bypass lowered pulmonary artery pressure, allowing pulmonary arterial clamping and avoiding right ventricular overload. All pulmonary hypertensive dogs undergoing bypass were successfully weaned from bypass, indicating a good hemodynamic response to transplantation. In pulmonary hypertensive dogs, transplantation resulted in significant decreases in systolic pulmonary artery pressure and pulmonary vascular resistance, and a significant increase in blood flow to the graft lung, whereas in controls the results were the reverse. CONCLUSIONS: Thus we were able to show that hemodynamics improved after single lung transplantation with cardiopulmonary bypass in a new pulmonary hypertensive animal model. These relatively larger animals are valuable for further studies of single, double, bilateral, and heart-lung transplantation for pulmonary hypertension.

Animals↗
PubMed1997

[Susceptibilities of bacteria isolated from patients with respiratory infectious diseases to antibiotics (1995)].

The bacteria isolated from the patients with lower respiratory tract infections were collected by institutions located throughout Japan, since 1981. Ikemoto et al. have been investigating susceptibilities of these isolates to various antibacterial agents and antibiotics, and characteristics of the patients and isolates from them each year. Results obtained from these investigations are discussed. In 23 institutions around the entire Japan, 567 strains of presumably etiological bacteria were isolated mainly from the sputa of 459 patients with lower respiratory tract infections during the period from October 1995 to September 1996. MICs of various antibacterial agents and antibiotics were determined against 74 strains of Staphylococcus aureus, 82 strains of Streptococcus pneumoniae, 104 strains of Haemophilus influenzae, 85 strains of Pseudomonas aeruginosa (non-mucoid strains), 18 strains of Pseudomonas aeruginosa (mucoid strains), 52 strains of Moraxella subgenus Branhamella catarrhalis, 25 strains of Klebsiella pneumoniae etc., and the drug susceptibilities of these strains were assessed except for those strains that died during transportation. 1) S. aureus. S. aureus strains for which MICs of oxacillin (MPIPC) were higher than 4 micrograms/ml (methicillin-resistant S. aureus) accounted for 52.7%. Arbekacin (ABK) showed the most highest activity against S. aureus with MIC80 of 0.5 micrograms/ml. Vancomycin (VCM) showed the next highest activity with MIC80 of 1 microgram/ml. These drugs showed the high activities against MRSA with MIC80S of 1 microgram/ml. 2) S. pneumoniae. Most of drugs tested showed potent activities against S. pneumoniae. Imipenem (IPM) and panipenem (PAPM), carbapenems, showed the most potent activity with MIC80S of 0.063 microgram/ml. Cefotaxime (CTX), cefmenoxime (CMX) and cefpirome (CPR) of cephems showed the next most potent activities with MIC80S of 0.25 microgram/ml. Erythromycin (EM) and clindamycin (CLDM) showed low activities with MIC80S 128 micrograms/ml or high. Among these strains, however, 48.8% and 65.9% of respective strains were quite toward sensitive these agents with MICs of 0.063 microgram/ml. 3) H. influenzae. The activities of all drugs were potent against H. influenzae test with all MICs at 4 micrograms/ml or below. Cefotiam (CTM), CMX, cefditoren (CDTR) and ofloxacin (OFLX) showed the most potent activity with MIC90S to 0.063 microgram/ml. 4) P. aeruginosa. (mucoid strains) IPM and tobramycin (TOB) showed the most potent activity against P. aeruginosa (mucoid strains) with MIC80S of 1 microgram/ml. Ceftazidime (CAZ), cefsulodin (CFS) and carumonam (CRMN) showed next potent activity, with MIC80S of 2 micrograms/ml. The MIC80S of the other drugs ranged from 4 micrograms/ml to 32 micrograms/ml. 5) P. aeruginosa (non-mucoid strains). TOB and ciprofloxacin (CPFX) showed the most potent activities against P. aeruginosa (non-mucoid strains) with MIC80S of 1 microgram/ml. The MIC80 of ampicillin (ABPC) was 128 micrograms/ml in 1994, it was 16 micrograms/ml in 1995. 6) K. pneumoniae. All drugs except ABPC were active against K. pneumoniae. CPR and CRMN showed the most potent activities against K. pneumoniae with MIC80S of 0.063 microgram/ml. The MIC80S of the other drugs ranged from 0.125 microgram/ml to 2 micrograms/ml. 7) M. (B.) catarrhalis. Against M. (B.) catarrhalis, all the drugs showed good activities with MIC80S at 4 micrograms/ml or below. And MICs of all strains were 8 micrograms/ml or below. IPM, OFLX and minocycline (MINO) showed the most potent activity with MIC80S of 0.063 microgram/ml. Also, we investigated year to year changes in the characteristics of patients, their respiratory infectious diseases, and the etiology. Patients' backgrounds were examine for 567 isolates from 459 cases. The examination of age distribution found that the proportion of patients with ages over 60 years was 66.3% of all the patients showing a slight increase over that in 1994. Proportion of differe

Adolescent↗
PubMed1997

[A study on competencies used by public health nurses in creating new health care systems in the community].

The purpose of this study is to clarify the competencies used by public health nurses in creating new health care systems in the community. The subjects were four public health nurses who were nominated by other public health nurses. As a method a qualitative method was used. Each subject was interviewed using a semistructured questionnaire which was made based on each system she had developed. Each interview was tape recorded and transcribed verbatim. Data were analyzed and divided by the seven domains proposed by Benner. The results showed that public health nurses took roles in six out of the seven domains of Benner. Among them the "Organizational and Work-Role Competencies" domain had a lot of content and was divided into more detailed seven subcategories. All four public health nurses were stimulated to create a new care system by exposure to a serious case and being moved deeply through visits to homes and hospital. The desire to solve the problem of individual clients leads to the establishment a new system in the community, showing the originality of the role of public health nurses who have nursing knowledge and who work in a regional government. In the process of building a health care system each public health nurse secured the budget or created a new measure of the regional government. It shows the significance of the role that public health nurses play in the regional government.

Community Health Services↗
PubMed1997

Retrograde cerebral perfusion with pharmacological cerebral protection in the repair of aortic arch aneurysm.

Twenty-six patients underwent resection and graft replacement of an aortic arch aneurysm (proximal arch,5; transverse arch:2, distal arch,8; and type A dissecting aneurysm. Retrograde cerebral perfusion with pharmacological cerebral protection was carried out during aortic arch aneurysm surgery. Prostaglandin E1, thiopental methylpredonisolone were administered for cerebral protection during core cooling. D-Mannitol and deferoxamine mesylate (radical scavengers) were administered for prevention of reperfusion injury. retrograde cerebral perfusion time was 48 +/- 16 minutes (range 20-80 minutes). Perfusion flow was 288 +/- 93 mL/min (range 150-500 mL/min). Since retrograde cerebral perfusion requires no arterial cannulation or aortic cross clamp, the operative field is simplified, and the risks of air and debris emboli to the brain were minimized. Reconstruction was designed to minimize the circulatory arrest time. Eleven cases underwent emergency surgery due to rupture and acute dissection. Five patients (19.2%) died (three from bleeding from the distal anastomosis, one from postoperative DIC and, one from intraoperative dissection). The remaining 21 patients survived neurologically intact. Retrograde cerebral perfusion with pharmacological cerebral protection is a very simple method to prevent air embolism or thromboembolism in aortic arch aneurysm surgery and allows aortic arch replacement in a bloodless field. In spite of the extended circulatory arrest time, recovery of consciousness was complete.

Adult↗
PubMed1997

Differences in the effects of cytokines on the expression of adhesion molecules in endothelial cells.

OBJECTIVES: Expressions of adhesion molecules on arterial endothelial cells are crucial events in initiation of atherosclerosis. Our recent study has shown that endothelial cells express endothelial leukocyte adhesion molecule-1 (ELAM-1) significantly due to stimulation with oxidized LDL, H2O2, or hypoxia. This current study is aimed at investigating temporal relations of the induction of ELAM-1, intercellular adhesion molecule-1 (ICAM-1), and vascular cell adhesion molecule-1 (VCAM-1) in cultured endothelial cells of the human thoracic aorta. METHODS: The activators examined were interleukin 1 alpha (IL-1 alpha), tumor necrosis factor alpha (TNF alpha), and interferon gamma (IFN gamma). Cells were incubated with each of the cytokines at 10 ng/ml for 0.5-48 hours. The adhesion molecules were determined by enzyme immunoassay. RESULTS: ELAM-1 appeared after stimulations by IL-1 and TNF alpha; ELAM-1 was induced by IL-1 after one hour, while it rose sharply after a 30-min stimulation by TNF alpha. The ICAM-1 expression was observed even in non-stimulated cells and further increased in proportion to duration of stimulation. No significant difference occurred between the effects of IL-1 and TNF alpha on the ICAM-1 expression. Weak expression of VCAM-1 was observed only by TNF alpha after 4-through 24-h stimulation. IFN gamma did not cause any changes in the expression of ELAM-1, VCAM-1, and ICAM-1. CONCLUSIONS: The present data indicate a specific time course for each induction of ELAM-1 and VCAM-1, but not ICAM-1. Therefore, the combination of molecules may play a role for endothelial cells to discriminate monocytes from such other cells as neutrophils and lymphocytes.

Aorta↗
PubMed1997

Neuroprotective effect of D-(E)-2-amino-4-methyl-5-phosphono-3-pentenoic acid in the gerbil model of transient global cerebral ischemia.

Effect of the new competitive N-methyl-D-aspartate (NMDA) antagonist D-(E)-2-amino-4-methyl-5-phosphono-3-pentenoic acid (CAS 137424-81-8, CGP 40116) was examined in a mongolian gerbil model of global cerebral ischemia. Effect of CGP 40116 was compared to that of another competitive NMDA antagonist, (+/-)-cis-4-phosphonomethyl-piperadine-2-carboxylic acid (CAS 110347-85-8, CGS 19755) under the same conditions. Drugs were administered intraperitoneally 30 min before bilateral carotid artery occlusion. At 4 days after the ischemia, locomotor activity was significantly higher in ischemic control mongolian gerbils in comparison with sham-operated mongolian gerbils. CGP 40116 at the dose of 10 mg/kg and CGS 19755 at the doses of 10 and 30 mg/kg significantly suppressed the increase of the motility. Seven days after ischemia, ischemic control group was still hyperactive compared to sham-operated group. CGP 40116 at the dose of 10 mg/kg and CGS 19755 at the dose of 30 mg/kg significantly reversed it. The number of survived neurons of ischemic control group was significantly less than that of sham-operated group at 7 days after ischemia. CGP 40116 at the dose of 10 mg/kg and CGS 19755 at the dose of 30 mg/kg significantly increased the number of survived neurons. It is concluded that CGP 40116 is more potent for amelioration of global cerebral ischemic damage than CGS 19755.

2-Amino-5-phosphonovalerate↗
PubMed1997

Effect of D-(E)-2-amino-4-methyl-5-phosphono-3-pentenoic acid on focal cerebral ischemia in cat.

The effect of the new competitive N-methyl-D-aspartate (NMDA) antagonist D-(E)-2-amino-4-methyl-5-phosphono-3-pentenoic acid (CAS 137424-81-8, CGP 40116) was examined in a cat model of focal cerebral ischemia. Effect of CGP 40116 was compared to that of another competitive NMDA antagonist, (+/-)-cis-4-phosphonomethyl-piperadine-2-carboxylic acid (CAS 110347-85-8, CGS 19755) under the same conditions. Drugs were administered intravenously 30 min before left middle cerebral artery (MCA) occlusion. After MCA occlusion for 8 h, infarction spreaded widely among caudate nucleus prepyriform cortex, amygdala and temporal lobe cortex in the ischemic hemisphere. CGP 40116 at the dose of 10 mg/kg and CGS 19755 at the dose of 30 mg/kg significantly decreased the infarcted area. CGP 40116 was effective in the frontal and central brain, although CGS 19755 showed neuroprotective effect in almost all sites. Thus, the compounds are potent neuroprotectants in focal ischemia.

2-Amino-5-phosphonovalerate↗
PubMed1997

[Surgical treatment of aortic dissection (Stanford type A) using hypothermic retrograde cerebral perfusion in patients older than 70 years of age].

Since 1991, 27 consecutive patients with aortic dissection (Stanford A) have been operated on using deep hypothermic retrograde cerebral perfusion (RCP). There were no differences in ECC time (247 +/- 15 vs 307 +/- 22 min), and RCP time (47 +/- 2 vs 47 +/- 3 min) between the aged (> or = 70 y.o., n = 11) and non-aged (< 70 y.o., n = 16) group. Although the aged group showed the higher incidences of postoperative neurological complications of prolonged emergence (2 cases) and delirium (3 cases), respiratory disorder (3 cases), and renal dysfunction (3 cases), there was no significant difference in hospital mortality (18% in the aged vs 13% in the non-aged). We concluded that RCP is well acceptable procedure for surgical treatment of the aged patients with aortic dissection.

Age Factors↗
PubMed1997

[A case of empyema with a bronchopleural fistula treated by a pedicle muscle flap with the thick parietal pleura].

A 65-year-old male with a bronchopleural fistula of 10 mm in diameter underwent thoracoplasty combined with a pedicle muscle flap following open thoracic window. He had been treated by gastrectomy and right upper lobectomy because of gastric perforation and lung tuberculosis before empyema. Sterilization for the empyema cavity through the thoracic window was done for 255 days, obliteration of the empyema cavity was achieved by a muscle flap with the thick parietal pleura. The parietal pleura which was not separated from the intercostal pleura which was not separated from the intercostal muscle was used for reinforcement of the muscle flap against the high intra-tracheal pressure. There was no postoperative relapse of empyema for 9 months.

Aged↗
PubMed1997

[Spectrum analysis of heart rate variability for the assessment of training effects].

The aim of our study was to investigate the effect of habitual exercise on the autonomic nervous system on the basis of spectral analysis of heart rate variability. We studied 24 healthy subjects. Eight were trained athletes (age 26.9 +/- 12.4 years, weight 58.6 +/- 7.9 kg, BMI 21.7 +/- 2.6 kg/m2) who routinely performed a minimum of 40 minutes of aerobic activity per week. The control population was represented by 16 untrained persons (age 27.1 +/- 11.9 years, weight 59.1 +/- 13.0kg, BMI 22.1 +/- 4.0kg/m2). There was no significant difference in age, gender, weight and BMI between two groups. After 10 minutes of supine resting, all subjects were instructed to perform 40W exercise on a mechanically braked bicycle ergometer for 10 minutes. Heart rate was continuously recorded according to the experimental protocol. Low and high frequency power were calculated by using fast Fourier transform. Differences of parameter values between two groups were examined by using t tests. Before loading, the athletes had a significantly lower heart rate (63.7 +/- 4.0 beats/min) than control subjects (73.0 +/- 9.1 beats/min). During ergometric loading, the coefficient of variation of heart rate (CV) and the high frequency power (HF) were significantly higher, and low frequency power (LF) was significantly lower in the athletes (CV 2.9 +/- 0.6, HF 0.5 +/- 0.2, LF 0.4 +/- 0.2) compared with the control subjects (CV 2.1 +/- 0.8, HF 0.3 +/- 0.1, LF 0.6 +/- 0.1). After loading, the athletes had a significantly lower heart rate. In conclusion, we found that there were significant differences in the spectral components of heart rate variability during exercise between athletes and control subjects. The results show that physical training could possibly increase parasympathetic activity (or decrease sympathetic activity).

Adolescent↗
PubMed1997

Rupture of a dissecting aneurysm into the superior vena cava in Marfan's syndrome.

Aneurysmal dilatation of the aorta with subsequent dissection or rupture occurs frequently in patients with Marfan's syndrome. These complications are among the major causes of death. We report the case of a 51-year-old man with annulo-aortic ectasia in Marfan's syndrome. Acute aortic dissection and rupture into the superior vena cava occurred 8 years after aortic valve replacement. The preoperative diagnosis was made by right heart catheterization and computed tomography. A markedly increased left-to-right shunt occurred with rapid enlargement of the fistula due to the fragility of the aortic wall characteristic of Marfan's syndrome. Postmortem examination demonstrated severe medial necrosis with rupture of the aortic wall into the superior vena cava which was adherent to the suture line of the aortotomy from the previous surgery. Type A aortic dissection with severe congestive heart failure strongly suggested rupture into the pulmonary circulation.

Aortic Dissection↗