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Biomedical subjects

M Okazaki

Publications and source records attributed to M Okazaki.

At least 325 records · Page 18Linked to original sources
PubMed1993

[Changes in bronchoalveolar cell profiles of asthma patients induced by long-term glucocorticoid therapy].

Effects of long-term glucocorticoid therapy on airway inflammatory cells were examined in 40 patients with bronchial asthma. 1. The dose of glucocorticoids required by asthmatic patients tended to increase and the level of serum cortisol tended to decrease with prolongation of the period of glucocorticoid therapy. 2. The proportion and number of lymphocytes in bronchoalveolar lavage (BAL) fluid decreased with prolongation of the period of glucocorticoid therapy. The proportion of BAL lymphocytes in asthmatic patients treated with glucocorticoids for more than 5 years was significantly lower than that in those treated for less than 4.9 years. 3. The proportion and number of BAL neutrophils increased with prolongation of the period of glucocorticoid therapy and the proportion of BAL neutrophils in patients treated with glucocorticoids for more than 10 years was significantly higher compared with those treated for less than 9.9 years. These findings indicate that long-term glucocorticoid therapy induces changes in airway inflammatory cell profiles, with a decrease in the number of lymphocytes and increase in the number of neutrophils.

Adult↗
PubMed1993

Chemoembolization for hepatocellular carcinoma via the inferior pancreaticoduodenal artery in patients with celiac artery stenosis.

Twenty-one patients with hepatocellular carcinoma (HCC) accompanied by extensive celiac artery stenosis or obstruction were treated by chemoembolization via the inferior pancreaticoduodenal artery (IPDA). The tip of the catheter was placed in the arteries in front of the confluence with the proper hepatic artery in 12 patients (group A: the proximal portion of the IPDA in 10, and common hepatic artery in 2), and in the proper hepatic artery or branches of it (group B) in 9 using a coaxial catheter system. Transient hyperamylasemia was observed in 10 of the 12 patients in group A and in 3 of the 9 patients in group B after chemoembolization. Splenic infarction developed in 8 patients in group A and in none in group B. Intrapancreatic fluid collection was present in 2 patients in group A following chemoembolization. No fatal complications were encountered. The 1-, 2-, and 3-year survival rates of the 10 patients in group A treated by only chemoembolization were 90, 57, and 23%, respectively (mean survival 780 days). The 1- and 2-year survival rates of 9 patients in group B were 85.8 and 85.8% (mean 879 days), respectively. Considering the severity of complications and the survival rates in groups A and B, chemoembolization by superselective catheterization into the hepatic artery via the IPDA is the treatment of choice. However, chemoembolization from the arteries in front of the confluence with the proper hepatic artery seems to be acceptable in cases of hypervascular HCC which fail to be superselectively catheterized.

Adult↗
PubMed1993

Long-term risk factors for bleeding after first course of endoscopic injection sclerotherapy: a univariate and multivariate analysis.

The purpose of this study was to define the risk factors linked to the rupture of esophageal varices following endoscopic injection sclerotherapy. A total of 197 patients with esophageal varices who had been treated by endoscopic injection sclerotherapy between 1985 and 1991 were observed for post-therapeutic bleeding from esophageal varices. Among 197 patients, 96 had esophageal varices and concomitant hepatocellular carcinoma. Analysis by the multivariate Cox's proportional hazard model disclosed that incomplete eradication of esophageal varices, the presence of hepatocellular carcinoma, and Child-Pugh classes were statistically significant predictors for rupture of esophageal varices after sclerotherapy. We conclude that complete eradication of esophageal varices is essential for sustained effectiveness of endoscopic injection sclerotherapy. The presence of hepatocellular carcinoma and a lack of hepatic functional reserve, as indicated by Child's classification, are also major determinants of post-therapeutic bleeding.

Carcinoma, Hepatocellular↗
PubMed1993

Chemoembolotherapy for recurrent hepatocellular carcinoma in the residual liver after hepatectomy.

The efficacy of transcatheter arterial chemoembolization using Lipiodol (TACE) to treat recurrent hepatocellular carcinoma (r-HCC) in the residual liver after radical hepatic resection was evaluated. During the last 8 years, TACE was performed in 68 patients with r-HCC for an aggregate total of 150 times. Of the 68 patients, 4 had a massive type r-HCC with tumor thrombus in the main portal vein (PVTT) at the time of the first TACE. Among the remaining 64 patients without PVTT, multiple r-HCCs were revealed in 46, and a single r-HCC in 18 by angiography and/or follow-up CT scans after the initial TACE. In 26 of the 68 patients (38.2%), at least one or more r-HCCs were fed not only by the hepatic arteries, but also by the extrahepatic collateral arteries, such as branches of the right inferior phrenic artery. The cumulative survival rates of these patients after hepatectomy and after the initial TACE for r-HCC were 98.6% and 87.1% for one year, 89.7% and 62.9% for 2 years, 74.0% and 34.3% for 3 years, 53.1% and 20.0% for 4 years and 40.3% and 0% for 5 years (mean survival duration: 1,647 days and 947 days), respectively. These results indicate that repeat TACE against r-HCC can help obtain long-term survival in patients with r-HCC. However, during TACE, we must give consideration to the newly developed collateral feeding artery to the r-HCC.

Adult↗
PubMed1993

[SPECT (single photon emission computed tomography) findings in 4 cases of neuronal migration disorders].

We report SPECT findings in four children with various types of neuronal migration disorders. SPECT of a patient with heterotopia showed a protrudent abnormal shadow into the centrum semiovale, the density of which was same as that of normal gray matter. The function and the metabolism of heterotopia appear same as those of the normal gray matter. SPECT of a patient with pachygyria showed decreased blood flow in the areas of thickened cortex. This finding seems to indicate hypofunction of those lesions. SPECT of a patient with hemimegalencephaly showed an increased blood flow in the ipsilateral hemisphere and decreased blood flow in the contra-lateral hemisphere. In the literature, increased contents of neuronal elements in the affected site and arterio-venous shunt with cardiac failure have been reported in hemimegalencephaly. These pathologies may be related to our SPECT findings. SPECT of a patient with cortical dysplasia showed extensive lesions of decreased blood flow which was more wide spread than abnormal lesions detected by MRI. SPECT may be more sensitive than MRI to detect cortical dysplasias.

Adolescent↗
PubMed1993

[Nuclear DNA ploidy pattern and cytological atypia in aspiration cytology of breast cancer].

The relationship between nuclear DNA ploidy pattern and cytological atypia in aspiration cytology of breast cancer was studied in 40 cases of primary breast cancers (T1: 14 cases; T2: 26 cases). They were divided into two groups, according to cytological specimens, high degree (H group) and low degree (L group). Twelve of 40 cases were classified into H group and 28 cases into L group. Fresh frozen materials were obtained from mastectomy specimens and nuclear DNA analysis was carried out by flow cytometry (FCM). Estrogen receptor (ER) and progesterone receptor were measured with the DCC method. Lymph node metastases were histologically seen in 17 cases; the ER positive rate was 55.0%, and the PgR positive rate was 42.5%. FCM revealed 21 cases (52.5%) with diploidy pattern and 19 cases (47.5%) with aneuploidy pattern. S-phase fraction in 17 cases (48.6%) exceeded 20%. L group had more diploid cases and ER positive cases than H group (p < 0.05, p < 0.01). No differences in other factors were seen between the two groups. In diploid cases, L group had more ER positive cases than H group (p < 0.02).

Biopsy, Needle↗
PubMed1993

Clinical effects of complex spa therapy on patients with steroid-dependent intractable asthma (SDIA).

The clinical effects of spa therapy (swimming training in a hot spring pool+inhalation of iodine salt solution+fango therapy) were examined in 52 patients with steroid-dependent intractable asthma (SDIA). Clinical effects were found in 36 of the 52 (69.2%) patients with SDIA. The efficacy was higher in the patients between the ages of 41 and 50 (87.5%) and between 51 and 60 (84.2%) than in those in the other age groups. Regarding clinical asthma types, the efficacy of spa therapy was higher in patients with type Ia-2 (83.4%), type Ib (77.8%) and type II (80.0%) than in those with type Ia-1 (54.2%). Efficacy seemed to be related to airway inflammation: the proportion of neutrophils and eosinophils in bronchoalveolar lavage (BAL) fluid was higher in patients with marked and moderate improvement compared with those with slight and no improvement. Ventilatory function was improved by complex spa therapy. %MMF and %V25 values increased by more than 20% after therapy in patients with type Ia-2, Ib and II asthma. Bronchial hyperreactivity to methacholine was suppressed after therapy. Any decreased function of the adrenocortical glands expressed by low serum cortisol levels improved after therapy, accompanied by a reduction in the dose of glucocorticoids necessary to control asthma attacks.

Adrenal Cortex↗
PubMed1993

Characteristics of airway responses in patients with bronchial asthma. Evaluation of asthma classification systems based on clinical symptoms and clinical findings.

Asthma was classified into three types according to clinical symptoms (clinical diagnosis, C.D.): Ia. simple bronchoconstriction type (further divided into two subtypes, type Ia-1 with 0-49 ml/day of expectoration and type 1a-2 with 50-99 ml/day); Ib. bronchoconstriction + hypersecretion type, and II. bronchiolar obstruction type. Asthma was also classified by a score related to clinical findings and examinations (score diagnosis, S.D.). The clinical features of each type of asthma according to the two classifications methods were compared. Type 1a-2 and 1b patients (C.D.) were characterized by mucus hypersecretion (more than 50 ml/day) and eosinophilia in the bronchoalveolar lavage (BAL) fluid. The characteristic findings for type II asthmatics (C.D.) were a lower %V25 value (less than 10%) and an increased proportion of neutrophils (more than 20%) in the BAL fluid. All of the patients classified as types 1a-1, Ib, and II by clinical diagnosis were evaluated as having the same types of asthma by score diagnosis. Patients with type Ia-2 evaluated by clinical diagnosis were classified as type Ib by score diagnosis, since these two types had similar pathophysiological features represented by the increased proportion of eosinophils in the BAL fluid.

Adult↗
PubMed1993

[Correlation between proportion of BAL cells and ventilatory function in patients with asthma].

The correlation between proportions of cells in bronchoalveolar lavage (BAL) fluid and ventilatory function was examined in 52 patients with asthma. 1. There was no significant correlation between the proportion of BAL lymphocytes and ventilatory function. 2. The proportion of BAL eosinophils correlated to a certain extent with ventilatory function: the values of %MMF, %V50 and %V25 were lower in patients with BAL eosinophils of 10-19.9% than in those with BAL eosinophils below 4.9%, and %V25 value was significantly lower in patients with a high proportion of BAL eosinophils (10-19.9%) compared with those with a low proportion of BAL eosinophils (0-4.9%). However, ventilatory function was not decreased in patients with BAL eosinophils of more than 20%. 3. The values of ventilatory parameters showed a tendency to decrease with increase in BAL neutrophils. The values of all parameters of obstructive ventilatory dysfunction were significantly lower in patients with BAL neutrophils of > 10% than in those with BAL neutrophils < 4.9%. A significant difference between patients with BAL neutrophils > 10% and < 9.9% was found in values of %V50 and %V25, and the values of %V50 and %V25 were significantly lower in patients with a high proportion of BAL neutrophils (> 10%) than in those with BAL neutrophils < 9.9%. These results suggest that the proportion of BAL eosinophils is to a certain extent related to ventilatory function of asthma patients and that the increase in proportion of BAL neutrophils is closely related to a decrease in values of obstructive ventilatory parameters.

Adult↗
PubMed1992

Emergent embolotherapy of small intestine hemorrhage.

The efficacy of emergent embolotherapy was evaluated in six patients suffering hemorrhage from the small intestine. Hemorrhage was from the jejunum in four patients, from the ileum in one, and from Meckel's diverticulum in one. Superselective embolization of the arcade of the small intestine artery branch was performed in all patients with a coaxial catheter. Embolic materials used were Gelfoam particles alone or Gelfoam particles plus coils in earlier cases and microcoils in recent cases. Complete hemostasis was immediately achieved in all patients, but one patient died of disseminated intravascular coagulation. After stabilization of the patient's condition by hemostasis, elective surgery was performed on three patients suffering small intestine ulcer. Histopathologically, no bowel infarction was noted but mild mucosal inflammation with submucosal edema was found in the jejunum of two patients. We recommend embolization for life-threatening small intestine hemorrhage, preferentially in situations where the blood vessel involved can be super-selectively occluded at the nearest level of the arcade of the vasa recta, lest the vasa recta should be occluded.

Adolescent↗
PubMed1992

Embolotherapy of massive duodenal hemorrhage.

Eleven patients with massive duodenal hemorrhage were treated by emergent embolization. Bleeding originated from duodenal ulcer in three patients, from duodenal tumor in one, from ruptured pancreaticoduodenal artery pseudoaneurysm in three, and from ruptured gastroduodenal artery pseudoaneurysm in four. Complete hemostasis was obtained immediately after embolotherapy in all cases. Three of these patients died during the hospitalization period, one of whom from duodenal infarction and pancreas necrosis induced by embolization. In three patients with duodenal ulcer, complete hemostasis was obtained only by the gastroduodenal artery embolization with Gelfoam particles. Seven patients with pseudoaneurysms of the gastroduodenal artery or its branches required not only blockage of blood flow from the celiac artery but also the superior mesenteric artery for complete hemostasis. Therefore, in patients presenting with duodenal hemorrhage, the possibility of dual blood supply to the duodenum should be considered. Emergent embolization represents a useful alternative to surgery for massive duodenal hemorrhage, but it carries a risk of complications in patients with previous gastroduodenal surgery or significant visceral atherosclerosis.

Adolescent↗
PubMed1992

Heterogeneous synthesis of fluoridated hydroxyapatites.

Fluoridated hydroxyapatites were synthesized with two different modes of fluoride supply: by supplying F(-)-free solution initially, followed by a F(-)-containing solution whose fluoride concentration was stoichiometrically equal to that of fluorapatite; and with the order of supply of these solutions reversed. Both of these heterogeneously synthesized fluoridated hydroxyapatites showed typical calcium phosphate X-ray diffraction patterns; and both had similar total fluoride contents (0.94 +/- 0.02 and 0.99 +/- 0.03 mmol/g, respectively), i.e. half of the maximum fluoride content of fluorapatite. However, they differed considerably in their physico-chemical properties. The former had a wider peak breadth of X-ray diffraction and a lower apparent solubility (Ca = 12.2 +/- 0.7 mmol/l) than the latter (Ca = 19.8 +/- 0.4 mmol/l) at 37 degrees C and pH 4.0. Wavelength dispersive spectroscopy attached to scanning electron microscopy gave clearly different spectra. Electron spectroscopy for chemical analysis of apatite pellets made by pressing and heating showed a slightly larger F1s signal at the crystal surface of the former, although the difference was not marked. These results suggest that two different types of heterogeneous fluoridated hydroxyapatites were formed, hydroxyapatite covered with fluorapatite and fluorapatite covered with hydroxyapatite.

Fluorides↗
PubMed1992

Hepatic resection is not enough for hepatocellular carcinoma. A follow-up study of 92 patients.

We followed up 92 patients who underwent curative hepatic resection for hepatocellular carcinoma between 1982 and 1991. The long-term survival rates for these 92 patients for 1, 3, and 5 years were 98.8, 81.6, and 57.3%, respectively. As of May 1991, the carcinoma had recurred in 52 patients (56.5%). Recurrent tumors usually occurred in the residual liver within 3 years after surgery but were not always located near the primary lesion. The biologic characteristics of the primary tumors, such as serum alpha-fetoprotein, tumor size, number of tumors, and portal involvement, were closely related to recurrence and long-term survival. However, the type of hepatectomy performed on the primary tumor had little influence on recurrence or long-term survival. We conclude that recurrence cannot be avoided by hepatic resection alone, much less with limited resection; postoperative positive adjuvant therapy is required to prevent recurrence for patients with satellite nodule and/or portal involvement.

Adolescent↗
PubMed1992

[Clinical studies on pediatric purulent meningitis--clinical symptoms and prognosis].

In 149 patients with purulent meningitis we encountered in the period of 20 years from 1970 to 1990, their clinical symptoms and prognosis were investigated. Death or sequela was noted in many of the patients having loss of consciousness, stiffness of the members and/or cyanosis as primary clinical symptoms, or having hypoalbuminemia (less than 2.5 g/dl) and/or thrombocytopenia as abnormal laboratory findings, or having excessive protein levels and/or excessively low sugar levels in cerebro-spinal fluid. Early initiation of adequate antibiotic therapy, as well as symptomatic treatment using transfusion, steroids and anticonvulsants, are important.

Female↗
PubMed1992

[Clinical studies on pediatric purulent meningitis--statistical analysis of etiology and therapy].

In a total of 149 children with purulent meningitis we encountered in our institute in the last 20 years, the causatives, the changes in therapeutic management and the prognosis were investigated. The causatives could be detected in 109 patients (73%): H. influenzae; 30 patients (20%), S. pneumoniae; 18 patients (12%), E. coli; 13 patients (9%), GBS; 7 patients (5%) and S. aureus; 6 patients (4%). These five causatives were detected in 49% of the total patients, or 67% of the patients in whom causatives could be detected. Of these five causatives, E. coli were detected the most frequently in the first half of 1970's, but, in recent years, the detection of GBS, S. pneumoniae and H. influenzae has been remarkably increasing. In spite of progress in antibiotics, the prognosis of the disease due to S. pneumoniae, GBS and S. aureus was poor. In the majority of the patients who died, the death came within five days after hospitalization due to loss of consciousness, convulsion etc. It is therefore necessary not only to initiate strong antibiotic treatment as soon as possible after early diagnosis, but also to take symptomatic measures such as steroidal treatment, treatment of shock etc.

Anti-Bacterial Agents↗
PubMed1992

NAD(P)H-dependent chromium (VI) reductase of Pseudomonas ambigua G-1: a Cr(V) intermediate is formed during the reduction of Cr(VI) to Cr(III).

An NAD(P)H-dependent Cr(VI) reductase (molecular weight = 65,000) was purified from a Cr(VI)-resistant bacterium, Pseudomonas ambigua G-1. Stoichiometric analysis of the enzymatic reaction showed that the enzyme catalyzed the reduction of 1 mol of Cr(VI) to Cr(III) while consuming 3 mol of NADH as an electron donor. Chromium(VI) was reduced to Cr(V) by one equivalent NADH molecule in the absence of the enzyme. Electron spin resonance analysis showed that Cr(V) species (g = 1.979) was formed during the enzymatic reduction. The amount of Cr(V) species formed was about 10 times larger than that of the nonezymatic reduction. These findings show that the Cr(VI) reductase reduced Cr(VI) to Cr(III) with at least two reaction steps via Cr(V) as an intermediate.

Chromatography, Liquid↗
PubMed1992

Intravascular foreign bodies: loop-snare retrieval system with a three-lumen catheter.

A foreign body retrieval system composed of a three-lumen catheter, a guide wire, and a wire loop nearly perpendicular to the axis of the catheter was used to retrieve catheter fragments located in the inferior vena cava in two patients and in the superior vena cava in one patient. Fragments were looped within 1 minute of catheterization and were retrieved without complication. Catheter fragments placed in the pulmonary artery of one dog were also successfully retrieved.

Animals↗