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Biomedical subjects

M Okuyama

Publications and source records attributed to M Okuyama.

At least 91 records · Page 5Linked to original sources

[Histological analysis of aging ciliary body].

The aging changes in human ciliary body were studied by histological analysis. Thirty four autopsy eyes were fixed in 2.5% formalin and 1.0% glutaraldehyde mixture. The age distribution was 12 eyes below 50 years of age 13 eyes between 60 and 70 years of age, and 9 eyes over 80 years of age. Serial sections of the ciliary body were made parallel to the limbus and vertical to the ciliary processes. From four areas (transitional portion between pars plana and pars plicata, posterior portion of pars plicata, middle portion of pars plicata, and anterior portion of pars plicata) a central section was selected. Histological analysis was done with the use of Azur II stained light microscopic pictures. The basement membrane of non-pigmented epithelium below 50 years of age was thinner than between 60 and 70 years of age. This finding may be related with lowering aqueous humor secretion with aging. Non-pigmented epithelium, blood vessels in the stroma, and muscle fibers in muscle tissue showed aging changes. The pigment epithelium, basement membrane, and muscle fibers in muscle tissue did not show aging changes in light microscopical analysis, but study of their fine structure is necessary.

Aged↗

Subzonal insemination with a single spermatozoon using manipulation assisted sperm adhesion onto the ooplasmic membrane in mouse ova.

A simple and successful method of microinjection of a single spermatozoon under the zona pellucida of a mouse oocyte has been developed. A characteristic of this method is that the tip of the sperm injection needle pierces the zona pellucida without touching the ooplasmic membrane. All the ova (277) used for this series of experiments had normal morphology after the injection procedure. Spermatozoa preincubated in culture medium for capacitation and those treated with ionophore A23187 for induction of acrosome reaction were used. In combination with some of these injections, a manipulation assisting the adhesion of the sperm head onto the ooplasmic membrane was employed. The fertilization rate (67.3%) of the ova injected with the ionophore-treated sperm using the sperm-adhesion treatment was significantly higher (P less than 0.005) than that obtained by the injection of the preincubated sperm without applying the adhesion treatment (23.6%). All three of the recipients that received the 24 fertilized ova became pregnant and gave birth to 11 offspring (45.8%). The inseminations performed with the sperm-adhesion treatment using the immotile sperm from the preincubated population and/or those from the ionophore-treated population did not result in fertilization in any case. These results suggest that the fertilization rate of subzonal insemination with motile ionophore-treated sperm can be improved by applying the sperm-adhesion treatment and that sperm motility might be involved in the establishment of fertilization, even after the adhesion of the sperm head with the mouse ovum membrane.

Animals↗

[Perioperative management for patients with hypertrophic cardiomyopathy undergoing noncardiac surgery].

We had two patients with hypertrophic cardiomyopathy for noncardiac surgeries. Case 1: A 74-year-old man for right nephrectomy received epidural lidocaine and nitrous oxide combined with 0.2-0.6% isoflurane. During the operation, heart rate and blood pressure were relatively unstable, but he woke up promptly after the operation. Early on the morning of the 2nd post-operative day, he was found dead on his bed. Case 2: A 52-year-old man for gastrectomy was anesthetized with nitrous oxide and halothane with continuous propranolol infusion. Through the operative period, heart rate and blood pressure were stable and postoperative course was uneventful. In these two patients, preoperative Holter ECG showed ventricular tachycardia, which may increase the risk of a sudden death. These cases demonstrate that general anesthesia with nitrous oxide combined with halothane, can be administered with a low risk in patients with HCM for noncardiac surgery and that postoperative intensive care unit monitoring is necessary for these patients for several days to prevent a sudden death.

Aged↗

[Clinical study of parathyroidectomy of secondary hyperparathyroidism in patients with chronic renal failure].

We performed parathyroidectomy for renal osteodystrophy due to secondary hyperparathyroidism on 16 patients with chronic renal failure who were refractory to medical management; subtotal parathyroidectomy on one patient and total parathyroidectomy with autotransplantation on 15 patients. Postoperative clinical improvement, i.e., bone and/or joint pain, pruritus and radiographic signs of renal osteodystrophy, was marked. After the operation, serum calcium decreased rapidly and adequate calcium replacement therapy was necessary. The levels of intact parathyroid hormone decreased rapidly and serum concentration of alkaline phosphatase gradually decreased for a few months postoperatively. Recurrence was diagnosed in one patient, who underwent excision of the transplanted parathyroid tissue. Osteomalasia due to hypoparathyroidism was not seen clinically in this series. In preoperative image diagnosis, ultrasonotomogram (US) showed the highest detective rate of the enlarged parathyroid glands. However, combination of US, computerized tomography and 99mTcO4(-)-201T1C1 scintigram can be recommended as a localizing diagnostic method for compensating the disadvantages of each method. Clinical results after parathyroidectomy for secondary hyperparathyroidism are considered to be good. However, long-term followup is mandatory for early detection of persistent hyperparathyroidism or hypoparathyroidism.

Adult↗

[Primary carcinoma in diverticulum of the bladder: a report of three cases].

The first case was in a 48-year-old man admitted with a chief complaint of macroscopic hematuria and sense of residual urine. A tumor in the diverticulum of the bladder was detected by cystoscopy, computed tomography (CT) and magnetic resonance imaging (MRI). We made the diagnosis of an invasive tumor in the diverticulum of the bladder. Total cystourethrectomy and ileal conduit diversion was performed. Histopathological finding was transitional cell carcinoma including squamous cell carcinoma. Adjuvant chemotherapy was performed. No recurrence and metastasis has been recognized for 12 months. The second case was a 56-year-old man having an intradiverticular tumor diagnosed by cystoscopy, CT, and MRI. Total cystectomy and ileal conduit diversion was performed. Histopathological findings was squamous cell carcinoma. No recurrence has been recognized for 8 months. The last case was an 81-year-old man. The patient had the complication of a primary progressive squamous cell carcinoma of the skin. Transurethral resection of diverticular tumor was performed under the diagnosis of superficial tumor. Histopathological findings revealed transitional cell carcinoma. One hundred and sixty one cases of tumor in the diverticulum of the bladder were reviewed. Importance of aggressive treatment including total cystectomy was emphasized.

Aged↗

[An epidemiological survey of group A, B, C & G hemolytic streptococci isolated from the Throat of Diabetic Children Streptococcicosis Study Group].

The incidence of group A, B, C & G hemolytic streptococci residing in the throat of children with diabetes was surveyed. The survey was carried out in August, 1982 and August, 1983. Included in the surveys were 136 diabetic children. The survey was also carried out with healthy school children at the same term as the contrast. The detection rate of the streptococci among the diabetic children was significantly higher than the healthy school children. A great portion of streptococci detected from these diabetic children was classified into group B, on the other hand, from the healthy school children, group A. Although from healthy school children, BIII, BIa and several other types were isolated, from diabetic children only BIa and BIII were isolated. The detection rate of the streptococci among the diabetic children was significantly higher in the early days in camp for improvement of diabetes than in the last day. In the latter case the detection rate was similar to that among healthy children. In the other words following antidiabetic therapy as diabetes improved the detection rate were also improved. Among these 136 diabetic children examined 31 gave positive cultures at both surveys each year. Serogroups or serotypes in each year examinations, isolates, were identical in 26 cases. Most of these groups were group B and the types were Ia and III.

Diabetes Mellitus↗

[A study on hemolytic streptococci (group A, B, C and G) isolated from throat of the middle-aged and advanced-aged--especially as compared with elementary school children].

Hemolytic streptococci were isolated from throat of middle-aged and advanced-aged and these organisms were classified into groups A, B, C and G. 1) Persons 15 to 39 years old were included in one group and persons from 40 years of age upward were divided into 5 groups every 10 years. Comparison of these groups were done. Generally, group B organisms were most often isolated. The detection rate of group B organisms was higher in the older age group. The detection rates of group A and G organisms were approximately equal, but both organisms were isolated from a few persons. No organism of group C was isolated from males, while only two strains belonged to group C organism were isolated from females. 2) A number of strains of group A hemolytic streptococci were isolated from school children, particularly in the lower classes. But the proportion of group B organism to isolated streptococci showed an increase in upper classes, noticeably in females. 3) For middle-aged and advanced-aged, blood samples were obtained simultaneously on examination of the throat, and ASO value and ASK titer were determined. ASO values were higher in persons infected with groups A, C or G organisms than in persons infected with group B organism or no hemolytic streptococcus. ASK titers revealed a similar results to ASO values, though the relation between ASK titers and isolated hemolytic streptococci was less positive.

Adult↗

High frequency of aspartic acid at position 57 of HLA-DQ beta-chain in Japanese IDDM patients and nondiabetic subjects.

The HLA-DQ beta-chain (DQB1) genes of 72 Japanese patients with insulin-dependent diabetes mellitus (IDDM) and 85 control subjects were studied with polymerase chain-reaction (PCR) amplification and allele-specific oligonucleotide hybridization. DQW4 (DQBBlank) and DQw9 (DQB3.3) were increased in IDDM patients compared with the control subjects, and DQB1.2, DQB1.9, and DQw7 (DQB3.1) were decreased. Thirty-five (48.6%) IDDM patients had both alleles carrying an aspartic acid at position 57 of the DQ beta-chain (Asp 57), 35 (48.6%) were Asp 57/non-Asp 57 heterozygous, and 2 (2.8%) had non-Asp 57 alleles only. Of 85 control subjects, the respective values for these three genotypes were 49 (57.6%), 29 (34.1%), and 7 (8.2%), respectively. The high frequency of Asp 57 alleles in both IDDM and control subjects contrasts with data for Whites. Therefore, the Asp 57 hypothesis that the presence of an aspartic acid at position 57 of DQ beta-chain provides protection against developing IDDM is not tenable for Japanese IDDM patients. The DRB1 gene, particularly position 57 of the DR beta-chain, may contribute to IDDM susceptibility in Japanese.

Adolescent↗

[A case of malignant lymphoma with various ocular manifestations].

A case of malignant lymphoma with a variety of ophthalmological findings was reported. The patient was a 65-year-old man with malignant lymphoma in retro-peritoneum (stage IV). Uveitis with hypopyon and secondary glaucoma appeared in his right eye, optic neuritis in his left eye. We compared clinical observations with histopathological findings and found that glaucoma was due to direct obstruction in the trabecular space by tumor cells and optic neuritis was due to the tumor cell infiltration into optic nerve.

Aged↗

The abnormal bridging vein: light and electron microscopic observations.

We observed a patient with an abnormal bridging vein having a thickened vessel wall and newly formed vessels within it. It was suggested that the former is a phenomenon accompanying capsule formation around hygroma and the latter, indicating recanalization, originates in cells along the luminal side. Our morphological observations provided the reactive pattern of bridging veins against brain damage.

Cerebral Veins↗

[Relationship of serum streptococcal antibodies to carrier state of beta-hemolytic streptococcus in throats of healthy schoolchildren].

The relationship of ASO, ASK and ASP to carrier state of beta-hemolytic streptococcus in throats of healthy schoolchildren was examined from September, 1980 to May, 1987. The responses to ASO significantly increased in children who detected group A, C and G streptococcus, and ASK in group A and G, and ASP in group A. The responses were especially high in children who detected group A, C and G streptococcus one after the other through the term of research, and in children detected another T type of streptococcus one after the other. Relatively high titers of ASO and ASK were obtained in sera of children from whom some groups or T types of streptococci were isolated several detection times. ASP titers were not concerned with these times. The elevation of antibodies in paired samples were found as follows; 7 cases in ASO, ASK and ASP together, 42 cases in ASO and ASK together, 3 cases in ASK and ASP together, 2 cases in ASO and ASP together, 41 cases ASO only, 38 cases in ASK only, 7 cases in ASP only. Among these cases with elevation of antibodies titers, several kinds of the change of streptococcal carrier state were observed between obtaining serum of twice. Especially 15 cases with change of carrier state from group A to group A were noticed. Among these 15 cases, 11 cases isolated another T type strain through the term of research, or found to contain the research-time when no streptococcal strain was detected. Both long term carrier state of the same group or the same type of streptococcal strain and change of carrier state of streptococcal group or T type lead the elevation of ASO and ASK titers.

Antibodies, Bacterial↗

An adrenocortical tumor secreting weak mineralocorticoids.

An adrenocortical carcinoma (15.5 g) secreting excessive amounts of steroids with weak mineralocorticoid activity in a 25-year-old woman was studied with particular reference to its in vivo and in vitro secretions of steroids. Severe hypertension, occasional low serum potassium and suppressed PRA were the major clinical findings, and were improved with removal of the tumor. In the preoperative stage, plasma levels of 11-deoxycorticosterone, 18-hydroxy-11-deoxycorticosterone, corticosterone and 18-hydroxycorticosterone were all increased. However, the plasma level of aldosterone was repeatedly normal. Although plasma levels of pregnenolone, 17-hydroxypregnenolone, progesterone and 17-hydroxyprogesterone were very high, those of other late step steroids, i.e. 11-deoxycortisol, cortisol, dehydroepiandrosterone, androstenedione and testosterone were almost normal. From these findings, a major etiological role of weak mineralocorticoids such as 11-deoxycorticosterone, 18-hydroxycorticosterone and corticosterone in her hypertension was suggested. Pregnenolone and 17-hydroxypregnenolone in tumor tissue were increased, but 11-deoxycorticosterone, corticosterone, aldosterone, cortisol and adrenal androgens such as dehydroepiandrosterone, androstenedione and testosterone were below normal or low normal. In vitro production of 11-deoxycorticosterone, aldosterone or cortisol by the tumor tissue slices was very low and scarcely responded to synthetic ACTH.

17-alpha-Hydroxypregnenolone↗