Search PubMed⌕ Search

Biomedical subjects

M Okada

Publications and source records attributed to M Okada.

At least 955 records · Page 53Linked to original sources
PubMed1994

Combined therapy in children and adolescents with IgA nephropathy.

We retrospectively evaluated renal outcome in a total of 38 children and adolescents with IgA nephropathy who were selected for 6-month therapy for clinical (proteinuria > 1 g/m2/24 hour) and pathologic (mesangial proliferation, crescent formation, and tubulo-interstitial changes) features suggestive of progressive renal failure. Seventeen patients (group A) were treated with a combination of prednisolone, cyclophosphamide and dipyridamole, and the remaining patients (21; group B) were treated with the same drugs plus warfarin. All the patients were followed-up for more than 2 years (range 2-10 years, mean 4.8). In both groups, the mean urinary protein excretion value was significantly reduced after the therapy, compared with that at entry into the therapy. The significant reduction continued for up to 6 years in group A and up to 5 years in group B. Creatinine clearance was stable until 5-6 years after the trial in both groups, but 4 patients progressed to end-stage renal failure after that period. Post-therapy biopsy was performed in 14 patients, and was compared with the pre-therapy biopsy. The activity score had improved in both groups, but the chronicity score did not. These results indicate that there was a temporary effect and limited benefit with this treatment of combined drugs for children and adolescents with IgA nephropathy. The additive effect of warfarin was not substantiated.

Adolescent↗
PubMed1994

[A case of acute aortic dissection with aortic regurgitation successfully treated by postoperative ECMO].

A case of acute aortic dissection (Stanford Type A) with severe aortic regurgitation successfully treated by postoperative ECMO was reported. The patient was 41-year-old man in shock condition and was transferred to Kobe University Hospital. Chest CT scan and echocardiogram revealed acute aortic dissection with severe aortic regurgitation. An emergent operation by Collins' method and resuspension of aortic valve were carefully performed. Consequent ECMO was necessitated because of postoperative left ventricular and respiratory failure. Thereby, ECMO using heparin-coated CBAS-MAXIMA membrane oxygenator, centrifugal pump, and tubes was established by arterial cannulation via the anastomotic site of the ascending aorta to prevent the obstruction of the aortic true lumen by the false lumen which may be enlarged by retrograde perfusion via the femoral artery. Left ventricular function and pulmonary function were improved after 6 hours and 20 minutes, thus ECMO was successfully weaned without any complications.

Adult↗
PubMed1994

[A case report of aneurysm of the diverticulum of the ductus arteriosus in the elderly].

A 82-year-old female was admitted to our department with complaint of hoarseness. Retrograde aortogram revealed an aneurysm arising from distal aortic arch. The aorta including the aneurysm was resected and replaced with woven Dacron graft under partial cardiopulmonary bypass. An Aneurysm of the diverticulum of the ductus arteriosus is rare in adult and because of its high fatality it should be resected.

Aged↗
PubMed1994

[A successful surgical correction of the intermediate type of common atrioventricular orifice--report of an adult case].

A 42-year-old female was admitted to our hospital because of exertional dyspnea. Preoperative color Doppler echocardiogram revealed massive left to right shunt through the ostium primum defect, moderate mitral and tricuspid regurgitation, and trivial shunt via the small ventricular septal defect. Preoperative cardioangiogram also demonstrated goose neck deformity of the left ventricle. At the operation, the piece of atrioventricular valve fused on the summit of the small scooped ventricular defect was detected, and the total correction consisted of patch closure of the ostium primum defect and mitral and tricuspid valvuloplasty was performed. Postoperative course was uneventful. This is the first adult case reported in Japan who was operated on for the intermediate type of common atrioventricular orifice.

Adult↗
PubMed1994

[Early diagnosis of acute rejection in single lung transplantation from the standpoint of pulmonary hemodynamics].

The aim of this study is to clarify the early phase of acute rejection of the single lung transplantation by the pulmonary hemodynamics. Twenty dogs were divided into 3 groups (Group I (6 dogs): Modified autotransplantation, Group II (6): Allotransplantation without immunosuppression, Group III (8): Allotransplantation with immunosuppression (CYA 10mg/kg, AZ 2mg/kg)). Cardiac output (CO) and pulmonary arterial (PA) flow of the transplanted lung were measured continuously using Doppler flow method. In Group I, PA flow was maintained at about 40% of CO for 2 weeks. However, in Group II, PA flow gradually decreased to 15% of CO on the 7th postoperative day (POC) and all animals died of rejection within 2 weeks after surgery. In Group III, PA flow decreased to 20% of CO on the 1st POD but, then increased gradually to 38% on the 14th POD. When rejection was induced by discontinuation of CYA and AZ, PA flow decreased to below 13% of CO within 3.7 days (mean) and perivascular cuffing was found in open biopsy, although findings on chest X-ray films remained unchanged. PA flow returned to 40% within 4.3 days (mean) by injecting methylprednisolone for 3 days. In conclusion, the measurement of pulmonary hemodynamics might be useful in the early diagnosis of acute rejection after single lung transplantation.

Acute Disease↗
PubMed1994

[A case of 15p tetrasomy associated with infantile spasms].

A seven-year-old boy with a 15p tetrasomy: [47, XY, + inv dup (15) (pter-->q13: :q13-->pter)] was reported. The clinical manifestation were as follows; infantile spasms, delayed development and slightly brownish coloured skin. But there were no other abnormal findings in neurological or physical examinations. This was the first case with 15p tetrasomy and infantile spasms.

Child↗
PubMed1994

Comparison of the effects of single morning and single bedtime doses of famotidine on intragastric acidity in patients with gastric ulcer.

The effects of single morning and single bedtime doses of famotidine on intragastric acidity were studied by 24-h intragastric pH monitoring in 16 patients with gastric ulcer. The patients were randomly allocated to the following regimen: one group (n = 8) received 40 mg famotidine at 8:30 AM and another group (n = 8) received the same dose at 10 PM. The morning group showed significant inhibition of gastric acidity during the 24-h and daytime measurements, compared to those of the bedtime group (p < 0.05 in 24 h, p < 0.01 in daytime). Conversely, the bedtime group showed a significant inhibition of gastric acidity during the nocturnal period compared to the morning group (p < 0.01). These results indicate that the relative importance of suppression of gastric acidity on the gastric ulcer healing process should be evaluated in a clinical trial.

Drug Administration Schedule↗
PubMed1994

Non-receptor tyrosine kinases in mammalian neurogenesis.

Several members of the Src family of non-receptor tyrosine kinases are expressed at high levels in embryonic neural tissues as well as in adult brain. Relatively little has been known, however, about their roles in neural development. Attempts to clarify this by production of mutant mice have been unsuccessful because of gene redundancy. We earlier isolated a new cytoplasmic protein tyrosine kinase, Csk, and showed that it inactivates uniquely all members of non-receptor tyrosine kinases in vitro. Here, we have generated Csk-deficient mouse embryos and shown that Csk is indeed an indispensable negative regulator for all non-receptor tyrosine kinases in vivo, and that regulated activity of these kinases is essential for normal development of mice at the neural stage. The signaling pathway through Src-family kinases during neurulation is also discussed.

Amino Acid Sequence↗
PubMed1994

[A case of aortic regurgitation combined with obstruction of the left coronary ostium caused by adhesion of left coronary cusp].

A case, 31-year-old female with aortic regurgitation and ostial obstruction of left coronary artery, was reported. Her chief complaint was effort angina. The coronary angiography showed obstruction of left coronary ostium with intact main stem and its branches, perfused from right coronary artery and the aortogram revealed aortic regurgitation of grade 3-4. Left Valsalva sinus was obstructed by adhesion of left coronary cusp. Each coronary cusps were resected, and aortic valve replacement with 23 mm SJM valve and coronary arterial bypass by means of in-situ graft of left internal thoracic artery underwent successfully. The pathological findings of aortic cusps were healed valvulitis without specific inflammation as syphilis or aortitis syndrome.

Adult↗
PubMed1994

[A case of intrathoracic goiter composed of two tumors].

A 70-year-old female was referred to our hospital because of swelling at her frontal neck and an abnormal shadow on a chest X-ray film. CT scan and MRI showed a 11.0 x 7.5 cm well-demarcated tumor in the upper mediastinum. Thyroidal scintigraphy revealed an slight accumulation, leading to a diagnosis of intrathoracic goiter. During operation the mass was found to be composed of two tumors. The upper tumor was attached with fibrous adhesion to the right lobe of cervical thyroid but no connection. Histological examination showed follicular but not malignant adenoma of the thyroid.

Adenoma↗
PubMed1993

Functional and physical interaction of protein-tyrosine kinases Fyn and Csk in the T-cell signaling system.

The Src-like protein-tyrosine kinase Fyn is associated with T-cell antigen receptor. Transient expression of actively mutated Fyn, having Phe-528 instead of Tyr-528 or Thr-338 instead of Ile-338, in Jurkat T-cells stimulated the serum response element (SRE), 12-O-tetradecanoyl-phorbol-13-acetate response element, cyclic AMP response element, and c-fos promoter. The stimulation of SRE was particularly prominent not only with active Fyn but also with normal (wild-type) Fyn. SRE was also stimulated by both normal and active Lck. Furthermore, normal and active Fyn stimulated transcription from the IL-2 gene promoter when transfected cells were stimulated by concanavalin A plus 12-O-tetradecanoylphorbol-13-acetate. Under the same conditions, Lck did not stimulate IL-2 promoter unless it was activated by mutation. Interestingly, a mutant Fyn, which has deletions within the SH2 region and so is able to transform chicken embryo fibroblasts, did not stimulate either the c-fos or IL-2 promoter, suggesting the importance of this region in T-cell signaling. Csk, which phosphorylates tyrosine residues in the negative regulatory sites of Src family kinases, down-regulated Fyn- and Lck-mediated stimulation of the serum response element and Fyn-mediated enhancement of IL-2 promoter activity. These data suggest that Fyn and Lck, whose activities are regulated by Csk, are involved in different phases of T-cell activation.

Amino Acid Sequence↗
PubMed1993

Increase in plasma concentration of ubiquitin in dialysis patients: possible involvement in beta 2-microglobulin amyloidosis.

beta 2-Microglobulin(beta 2-M) amyloidosis is a serious complication of dialysis therapy; however, its pathogenesis is still unclear. Recent studies have indicated that ubiquitin has amyloid enhancing factor activity, raising the possibility that ubiquitin plays a role in beta 2-M amyloidogenesis. In this study, synovial tissue from patients with long-term dialysis was examined immunohistochemically. The synovial tissue was labeled with anti-ubiquitin antibody, indicating co-deposition of ubiquitin with beta 2-M amyloid. To elucidate the involvement of plasma ubiquitin, we established a specific radioimmunoassay for ubiquitin. Using this method, we observed that the plasma concentration of ubiquitin-like immunoreactivity in dialysis patients was significantly higher than that in normal subjects. In chronic renal failure patients, the plasma concentration of ubiquitin-like immunoreactivity was also significantly higher than that in normal controls, which finding suggests that a reduction in renal clearance is, at least in part, responsible for the increased plasma concentration of ubiquitin. In dialysis patients, plasma concentrations of ubiquitin-like immunoreactivity in patients with carpal tunnel syndrome, one of the major symptoms of beta 2-M amyloidosis, were significantly higher than those in patients not exhibiting this syndrome. These results suggest a possible involvement of plasma ubiquitin in beta 2-M amyloidosis.

Amyloidosis↗
PubMed1993

Plasma-free and sulfoconjugated MHPG in major depressive disorders: differences between responders to treatment and nonresponders.

The plasma levels of free and sulfoconjugated forms of 3-methoxy-4-hydroxyphenylglycol (MHPG) were examined before and after treatment in 16 patients with unipolar major depressive disorders without melancholia. The patients were treated with intravenous administration of clomipramine for 4 weeks. Seven depressive disorder patients who showed marked improvement (the improvement group) revealed significant reduction in their plasma sulfoconjugated MHPG levels. In 6 depressive disorder patients who showed no improvement (the no-improvement group), the plasma sulfoconjugated MHPG levels showed no significant change after treatment. The remaining 3 patients, who showed ambiguous change after treatment, were excluded from the analysis. Levels of plasma-free MHPG showed significant change after treatment in neither the improvement group nor in the no-improvement group. It is suggested that levels of plasma sulfoconjugated MHPG may serve as an indicator of brain noradrenergic activity.

Adolescent↗