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Biomedical subjects

M Okada

Publications and source records attributed to M Okada.

At least 667 records · Page 37Linked to original sources
PubMed1997

[An emergent surgical case of acute massive pulmonary embolism supported by antithrombotic percutaneous cardiopulmonary support system].

We present an emergent surgical case of massive pulmonary embolism. A 57-year-old male patient was refereed to our medical center for progressive dyspnea. He was intubated because of severe hypoxia. Pulmonary arteriography revealed massive pulmonary embolism. In the catheter laboratory he fell in shock and the heart was arrested, antithrombotic percutaneous cardiopulmonary support (PCPS) was introduced immediately. Emergent thrombectomy was carried out consequently under moderate hypothermic complete cardiopulmonary bypass. Up to 30 x 20 x 10 mm in size fresh clots were removed. Antithrombotic PCPS and IABP were maintained for 168 hours postoperatively. There were no hemorrhagic complication during the support because low dose heparin was administered continuously to keep ACT around 150 sec. He discharged from the hospital two months later and alive in good health. In conclusion, antithrombotic PCPS is very useful to care massive pulmonary embolism with thrombectomy.

Acute Disease↗
PubMed1997

[Serum apolipoprotein E-rich HDL-C levels in the subjects with hyperalphalipoproteinemia].

To clarify an increasing factor of serum apolipoprotein E-rich HDL-C(apo E-rich HDL-C) level in the patients with hyperalphalipoproteinemia(HALP), we characterized the relationships between the serum apo E-rich HDL-C levels and, apolipoprotein E genotypes and cholesteryl ester transfer protein(CETP) gene mutations using healthy(n = 46) and HALP subjects(HDL-C > or = 100 mg/dl, n = 67). Serum apo E-rich HDL-C level of healthy subjects was significantly different from that of HALP subjects. Frequencies of apo E allele of all subjects studied were consistent with previous other reports. It was, however, demonstrated that apo epsilon 4 allele decreases the apo E-rich HDL-C level in all HALP subjects. On the other hand, the G to A mutation in the intron 14 splice donor site(114A) and Asp442 to Gly mutation in the exon 15(D442G), were analysed by polymerase chain reaction-single strand conformation polymorphism(PCR-SSCP) method. Then we compared the apo E-rich HDL-C levels between the HALP subjects in the almost general population of apo E 3/3 with and without CETP gene mutation. There was strong tendency that the existence of CETP mutations increased the serum apo E-rich HDL-C level, comparing with the HALP subjects without these mutations. Therefore, we suggested that the increasing of serum apo E-rich HDL-C level was caused by the CETP deficiency and its level was affected by apo E genotypes.

Apolipoproteins E↗
PubMed1997

[A case of hemodialysis-associated innominate vein stenosis inducing superior vena cava syndrome].

Twenty years after making an arteriovenous shunt in the left arm, a 45-year-old man on hemodialysis developed progressive swelling in the face to left arm and venous dilatation on the left anterior chest. Venogram disclosed severe stenosis of the left innominate vein at the junction of the superior vena cava, which was considered to be a primary lesion because he had no history of subclavian vein cannulation or mediastinal disease. Surgical resection of the stenotic lesion and direct anastomosis of the innominate vein resulted in a rapid recovery of the symptom of venous hypertension. This is a rare case of hemodialysis-associated large vein complication leading to superior vena cava syndrome.

Arteriovenous Shunt, Surgical↗
PubMed1997

[Delineation of calf deep veins using 2D-TOF MR venography without contrast media: efficacy of tourniquet and leg-warming].

We evaluated the imaging quality of 2D-TOF MR venography of the lower part of the leg and the efficacy of a tourniquet around the knee and leg-warming. In 8 healthy volunteers, MR venography was carried out under the following four conditions: (a) usual MR venography, (b) MR venography with tourniquet around the knee, (c) MR venography after leg-warming and (d) MR venography with tourniquet after leg-warming. Our results suggested that MR venography with tourniquet after leg-warming is best suited for imaging the veins of the leg. We also compared the diagnostic image quality of MR venography and conventional contrast venography in 7 patients with varices. The results showed no significant differences between the two methods. We conclude that MR venography with tourniquet after leg-warming is a technique that provides reliable information about the veins of the leg.

Adult↗
PubMed1997

Hepatectomy of right superior portion (segment VII and VIII) combined with right hepatic vein reconstruction: a case report.

A 63-year-old man was admitted for the surgical treatment of hepatocellular carcinoma in the segment VIII. The tumor was 4 cm in size, and the major trunk of the right hepatic vein and a branch of the middle hepatic vein were compressed by the tumor on preoperative hepatic venogram. To preserve the remnant liver function, resection of segments VII and VIII combined with right hepatic vein reconstruction was attempted. Right hepatic vein was reconstructed using an autologous external iliac vein graft after resection of segments VII and VIII with the reason that the inferior right hepatic vein was small in this case and the congestive change was recognized on the surface of segment V and VI after temporary clamp of the right hepatic vein. The postoperative course was uneventful, and the grafted portion was patent on postoperative hepatic venogram. Postoperative pathological examination revealed that poorly differentiated hepatocellular carcinoma of 4 cm x 3.5 cm in size existed in the segment VIII, and directly infiltrated to the main trunk of the right hepatic vein. This is uncommon operative method, but may be useful for preservation of the remnant liver function.

Carcinoma, Hepatocellular↗
PubMed1997

[A surgical case for the huge chronic expanding hematoma developed in the thoracic cavity].

We report a case of operation against chronic expanding hematoma developed in the pleural cavity of the patient who were treated as anaplastic anemia. 69-year-old man had been underwent thymectomy because of the thymoma and hemogenic pleural effusion 8 years ago. Then, last year, he was pointed out severe thrombocytopenia and underwent transfusion of thrombocyte. In the same period, chest X-ray examination revealed development of the tumor-like shadow in the left lung field. The abnormal shadow has enlarged, so the patient admitted us. X-ray findings revealed the huge tumor occupied completely the left pleural space. He was also pointed out severe pancytopenia (WBC: 2,600/mm3, RBC: 172 x 10(4)/mm3, thrombocyto: 1.9 x 10(4)/mm#), and the examination of bone marrow revealed anaplastic anemia. Thoracotomy was underwent, and the tumor was resected. Pathological diagnosis of the tumor was huge hematoma. Negative pressure in the pleural space would keep the hemorrhage and make hematoma huge. The hematoma in the pleural space should be resected as soon as the diagnosis is decided.

Aged↗
PubMed1997

Reactivity of recombinant Treponema pallidum (r-Tp) antigens with anti-Tp antibodies in human syphilitic sera evaluated by ELISA.

We evaluated the immunoreactivity of recombinant Treponema pallidum (r-Tp) antigens with human sera by indirect enzyme-linked immunoabsorbant assay (ELISA). We expressed antigens with a molecular weight (MW) of 17KDa, 15KDa, 47KDa, and 42KDa, which are believed to be major immunoreactive membrane proteins of Tp cells. The expressed proteins were described by adding the prefix M, S, and G to the corresponding Tp antigens, namely, mature antigens, signal sequence containing antigens, and glutathione s-transferase (GST)-fused antigen in this report. A rather high expression occurred for M47 and S42 proteins in the Escherichia coli system, whereas for M15 and M17 proteins, a poor expression was observed. However, a fairly high expression occurred for G15 and G17. Thus expressed proteins were purified by means of chromatographies to a level of > 95%, and the purified proteins were found to be reactive with TPHA positive serum by Western blotting (WB). An ELISA performed with a serum of 1/1000 dilution using these purified antigens for coating on the solid phase showed that G17 antigen was more effective in detecting syphilis antibodies in human serum than M47, S42, and G15. There was a good consistency between ELISA and TPHA, whereby the cutoff indexes (CI) on ELISA showed a correlation coefficient of 0.7276 in logarithmic TPHA titers.

Animals↗
PubMed1997

[The present and future of clinical physiologic tests].

The symposium on clinical physiologic tests was designed in the 44th congress of all central laboratory divisions of national university hospitals at 28, 29 May in 1997. The title of symposium was "the present and future of clinical physiologic tests" which was named by professor M. Itoh. Four symposists were nominated among the specialists on clinical physiologic tests of members of above congress. Professor M. Itoh and Professor H. Kawaguchi spoke about Erectric Cardio Graphy (ECG) and main heart function tests and Professor M. Kambe spoke about pulmonary function tests and Professor M. Okada spoke about the using methods of clinical physiologic test data in remote and distant medicine. The special feature of clinical laboratory division in Japanese large hospitals is that has clinical physiologic tests part and the clinical laboratory division of hospitals in foreign countries has no clinical physiologic tests part. So, we expect more development of clinical physiologic tests part in nearly future.

Asthma↗
PubMed1997

Cerebral complications and distal false lumen in the repair of aortic dissection with retrograde cerebral perfusion.

BACKGROUND: In aortic dissection, patent distal false lumen at long-term follow-up leads to complications. We investigated the feasibility of an open distal anastomosis under retrograde cerebral perfusion. METHODS: During a 15-year period (1981-1995), 51 patients with type A dissection underwent 59 surgical repairs. In 1990, a distal open anastomosis with retrograde cerebral perfusion (group II) was introduced to replace the aortic cross clamp method (group I). Mean retrograde cerebral perfusion time was 50 minutes (range 22 to 65 minutes) with no neurologic sequelae in surviving patients. RESULTS: Operative mortality was 28.6% in group I, and 16.1% in group II. At long-term follow-up, dilatation of the false lumen (more than 50 mm in diameter) occurred in 56.2% (9/16) in group I, and 4 patients died of aortic rupture. There was no mortality in group II, and dilatation of the distal false lumen occurred in only 15.3% (p<0.05). CONCLUSIONS: Use of retrograde cerebral perfusion in aortic dissection allowed for adequate time to perform a safe, open, distal anastomosis. Intraoperative cerebral complications and enlarged patent false lumens decreased significantly.

Acute Disease↗
PubMed1997

The role of cadherin-catenin-cytoskeleton complex in angiogenesis: antisense oligonucleotide of plakoglobin promotes angiogenesis in vitro, and protein kinase C (PKC) enhances angiogenesis through the plakoglobin signaling pathway.

Angiogenesis plays an important role in various diseases and conditions such as malignant tumor, wound healing, and atherosclerosis. Since cell-to-cell adhesion may play a key role in angiogenesis, we investigated the effect of the cadherin-catenin-cytoskeleton complex on angiogenesis in human umbilical vein endothelial cells (HUVECs). Immunofluorescence staining revealed that alpha-catenin, beta-catenin, and plakoglobin were concentrated at cell-cell contacts in HUVECs. Antisense oligonucleotide (AS-oligo), complementary to the region of human plakoglobin was dissolved in saline and applied to the media at 1 mM every 12 h for 4 days, and sense oligonucleotide (S-oligo) was used as control. HUVEC migration from an injury line was enhanced by AS-oligo. Interestingly, HUVECs migrated in line with S-oligo, and in a scattered fashion with AS-oligo. Tube formation on Matrigel occurred earlier with AS-oligo than with S-oligo. These findings indicate that plakoglobin inhibited HUVEC migration and tube formation (angiogenesis) by regulating cell-cell adhesion.

Cadherins↗
PubMed1997

[Development of extracorporeal membrane oxygenation for neonates with severe respiratory failure].

Extracorporeal membrane oxygenation (ECMO) is one of the most highly developed artificial organ treatment of the last decade. Especially for severe neonatal respiratory failure, ECMO has become standard treatment in Japan following the same pattern as in the USA. In the USA, more than 12,000 infants have been registered for ECMO treatment by the Extracorporeal Life Support Organization (ELSO), and their total survival rate is above 80%. Recently, to avoid ligating the carotid artery, most neonates who required ECMO have been supported by a veno-venous (V-V) bypass using a double-lumen catheter via the right internal jugular vein into the right atrium. To prevent bleeding complications, the introduction of Nafamostat Mesilate and the development of a heparin-coated system would be advantageous. Progresses in these instruments and perfusing techniques might enlarge the indications of ECMO. We performed an experiment on fetus ECMO as artificial placenta. The fetuses were incubated for 10-237 hours by A-V ECMO using a centrifugal pump successfully and maturation of the lung was revealed. In the future the fetus ECMO could be introduced clinically as a back-up system for fetal surgeries and incubation for extra-premature infants.

Cystic Adenomatoid Malformation of Lung, Congenita↗
PubMed1997

Internal structure of the temporomandibular joint and the circumferential bone: comparison between dentulous and edentulous specimens.

To clarify changes in the trabecular structure due to loss of the teeth, the author compared soft X-ray images and morphological measurement values of the mandibular condyle and articular eminence between dentulous and edentulous specimens. The center of the skull base containing the temporomandibular joint was removed along the Frankfort horizontal and median sagittal planes. A block in the center of the cranial base was rejected using the Frankfort horizontal plane and median sagittal plane as references. The specimens were embedded in polyester resin by the routine method. The hardened specimens were horizontally cut into 500 microns sections and photographed using soft X-ray films. Soft X-ray of each section was taken for observation by naked eye and morphometry by computer. Observation of the compact bone in the articular eminence showed thinner compact bone on the posterior slope of the articular eminence, which is a functional plane, than on the anterior slope of the articular eminence. There was a trabecular bone group on the lateral area running from the compact bone on the posterior surface of the articular eminence into the zygomatic arch and a thick trabecular bone group in a network pattern on the medial area. In the central area of the mandibular condyle, spongy bone was surrounded by oval compact bone, and the internal trabecular bone ran anteromedially in nearly the same pattern as the arrangement of the lateral pterygoid muscle. At all sites, the density, width, extent, and index indicating the complexity of the trabecular bone had higher values in dentulous specimens than in edentulous specimens.

Aged↗
PubMed1997

Anatomical study of the pectoral branch of thoracoacromial artery.

Reconstructive surgery uses various musculocutaneous flaps following resection of head and neck malignant tumor. Numerous anatomical studies have reported that the thoracoacromial artery arises from the axillary artery, but those findings have not been completely confirmed. The aim of this study was to investigate the path from the origin of the thoracoacromial artery until its pectoral branches enter the pectoralis major muscle. The following results were obtained. 1. There were no cases in which the thoracoacromial artery arose from the third part of the axillary artery. 2. There were differences between the left and right sides in the vertical and horizontal origins of the thoracoacromial artery in relation to the clavicle and median line. 3. Pectoral branches showed a single origin from the thoracoacromial artery most frequently. 4. Pectoral branches descend in parallel to the median line most frequently on the right side and descended medially to the median line most frequently on the left side. 5. The largest number of branches approached the venter vertically at the height of the third rib. There findings suggest that, during operations involving a musculocutaneous flap, the surgeon must pay attention to the differences in vascular morphology of the right and left sides.

Aged↗
PubMed1997

Anatomical study of arrangement and attachment of the medial pterygoid muscle in Japanese men.

We precisely examined the origin, attachment, manner and insertion of the medial pterygoid muscle to clarify the relationship between muscle morphology and mastication movement. The muscular bundle attachment of the medial pterygoid muscle at the origin could be divided into three types; 1) the muscle was attached to the inner surface of the medial pterygoid plate with a strong tendon, 2) to the posterior maxilla wall with a strong tendon, and 3) directly to the periosteum of the inner surface of the lateral plate without a tendon. Provided that the muscular bundles had a firmly tendinous attachment under strong and significant force during their functioning, significant force would be applied to the medial pterygoid muscle in two directions. Observations of the intersection with the medial pterygoid muscle in the posterior wall of the maxillary bone at the origin revealed intersecting fibers or tendon fusion in all 55 specimens. Since there are different muscular bundle groups within the medial pterygoid muscle, we expect to elucidate more of masticatory function by observing other masticatory muscles as well as the medial pterygoid muscle.

Adult↗
PubMed1997

Increased portal endothelin-1 level is associated with the liver function after cardiopulmonary bypass in rabbits: influence of hypothermia on the damage.

The purpose of this study was to prove the hypothesis that ET-1 production is increased in the splanchnic-hepato circulation during cardiopulmonary bypass (CPB) with or without hypothermia and this greatly affects hepatocellular function after surgery. Twelve Japanese white rabbits were used. In group I (n = 6), the rectal temperature was kept at 37.0 degrees C during CPB (90 min). In group II (n = 6), the rectal temperature was lowered to 26 degrees C during the first 30 minutes and then increased to 37 degrees C for the following 60 minutes. In group I, surface liver tissue blood flow (LBF) remained stable during CPB. While, in group II, LBF was significantly reduced to 66.9% of baseline values during hypothermic CPB, but it increased during the rewarming phase to 84.3% of the baseline value (p = 0.0070). At the end of CPB, portal ET-1 levels were increased in both groups, but they were significantly higher in group II (7.32 +/- 0.50 pg/ml and 9.29 +/- 0.61 pg/ml, respectively). Serum GOT, GPT, LDH and arterial ammonia levels were also higher in group II. Portal ET-1 levels had a significant positive correlation with those liver enzymes. Histopathological examination after CPB showed severe damage of the hepatic parenchyma in zone 3 associated with microvesicular fatty infiltration in group II.

Analysis of Variance↗