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Biomedical subjects

M Ozaki

Publications and source records attributed to M Ozaki.

At least 19 recordsLinked to original sources

A woman who required long-term mechanical ventilation to treat limbic encephalitis during pregnancy.

We describe our experience with a woman who had severe non-herpetic acute limbic encephalitis at 20 weeks' gestation. Despite receiving mechanical ventilation for about 3 months because of impaired consciousness and frequent convulsions, she had a normal delivery and an uneventful recovery with no sequelae. The patient did not respond to treatment with antiviral agents. Anticonvulsant agents were given while monitoring plasma drug concentrations. Early treatment and the prevention of complications apparently contributed to good outcomes in the mother and child.

Adult↗

Entropy indices vs the bispectral index for estimating nociception during sevoflurane anaesthesia.

BACKGROUND: It is now possible to acquire and process raw EEG and frontal EMG signals to produce two spectral-entropy-based indices (response entropy and state entropy) reflective of analgesic and hypnotic levels during general anaesthesia (with the Datex-Ohmeda S/5 Entropy Module, Datex-Ohmeda, Helsinki, Finland). However, there are no data available on the accuracy of the Entropy Module in estimating nociception during sevoflurane anaesthesia. METHODS: Forty female patients were enrolled in the present study. Each patient was allocated randomly to one of four end-tidal sevoflurane concentration (ET(sev)) groups (1.3, 1.7, 2.1 or 2.5%). A BIS Sensor (Aspect Medical Systems, Newton, MA) and an Entropy Sensor (Datex-Ohmeda) were applied side-by-side to the forehead. The bispectral index (A-2000 BIS Monitor, version 3.4, Aspect Medical Systems), response entropy, state entropy and patient movement were observed after electrical stimulation (20, 40, 60 and 80 mA, 100 Hz, 5 s) and after skin incision during sevoflurane anaesthesia (1.3, 1.7, 2.1 or 2.5%). Accuracy of the EEG variables in differentiating the intensity of electrical stimulation was estimated by the prediction probability (P(K)) values. RESULTS: Response entropy and state entropy [median, (range)] before skin incision were significantly lower in patients who did not move [29 (15-41) and 24 (14-41)] than in those that did [38 (24-53) and 37 (24-52)], but there was no significant difference in BIS. All EEG variables increased significantly (P<0.0001 for all) with increases in the intensity of electrical stimulation. The difference between response entropy and state entropy increased with increases in the electrical stimulation (P<0.0001). However, no EEG variables could differentiate the intensity of the electrical stimulations accurately because of low P(K)-values (P(K)<0.8). CONCLUSION: Noxious stimulation increased the difference between response entropy and state entropy. However, an increase in the difference does not always indicate inadequate analgesia and should be interpreted carefully during anaesthesia.

Adult↗

Propofol EDTA and reduced incidence of infection.

Propofol formulated in a lipid vehicle supports the growth of microorganisms. There have been worldwide reports of extrinsic microbial contamination of propofol leading to outbreaks of serious postoperative nosocomial infections. Therefore it is essential that medical professionals follow strict aseptic precautions when handling propofol, as recommended by manufacturers of propofol and the Centers for Disease Control and Prevention. Non-adherence to these recommendations increases the risk of nosocomial postoperative infections, which impose a heavy burden of morbidity and mortality and have serious economic consequences. It has also been recommended that the use of EDTA-containing formulations of propofol be considered. In vitro studies have confirmed that EDTA added to propofol retards microbial growth. Data on the incidence of nosocomial infections before and after the introduction of propofol with EDTA indicates that there have been no further cluster outbreaks and individual nosocomial infections appear to have been reduced. The addition of EDTA is an additional safety precaution to good aseptic practice.

Anesthetics, Intravenous↗

Study on risk management of heavy metals for reuse of biosolids.

The behaviour of heavy metals was investigated at 22 wastewater treatment plants (WWTPs). In addition, the survey of heavy metal balance was conducted in detail at one WWTP. For the measurement, 22 types of heavy metals were selected from the chemical materials of pollutant release and transfer register (PRTR). There were some heavy metals, which were detected not in wastewater but in dewatered sludge. By means of the detailed survey at one WWTP, 60 to 80% of some heavy metals, such as B, Mn, Co, Ni and Mo, were discharged with treated water. According to the results of PRTR, Zn, B and Mn accounted for a large part of the discharge into the water course. To estimate the behaviour of heavy metals in the environment, leaching tests were applied to the products made of biosolids. During a series of leaching tests for building materials, it was observed that the concentration of heavy metals was very small, but the ratio of increase keeps a constant value. Therefore, it was considered that the acid extractable contents of heavy metal would be important.

Environmental Monitoring↗

Protective effect of diltiazem on hepatic ischemia-reperfusion injury in rats by improving liver tissue blood flow.

BACKGROUND: Cytosolic calcium ions are known to play an important role in ischemia-reperfusion (IR) injury. However, the protective effect of calcium channel blockers remains controversial in liver IR injury. Moreover, calcium channel blockers improve hepatic IR injury not due to blocking an increase in hepatic calcium concentration. Therefore, we hypothesized that calcium antagonists protected a liver from IR injury by a vasodilatory action rather than by the inhibition of an increase in Ca2+ within parenchymal cells. This study evaluated the effects of diltiazem, a calcium channel blocker, on liver energy metabolism and blood flow after IR injury. METHODS: Twenty-seven rats underwent hepatic ischemia for 30 minutes followed by 60 minutes of reperfusion. The animals were allocated into group C (without drug); group D5 (diltiazem, 5 microg/kg per min); or group D10 (diltiazem, 10 microg/kg per min). Diltiazem was infused before laparotomy and then throughout the experiment. RESULTS: After 60 minutes of reperfusion, liver tissue blood flow and ATP concentrations were significantly higher in group D10 than the other animals (both, P < .05). Changes in ATP values strongly correlated those observed in blood flow (R = 0.80, P < .001). CONCLUSION: Diltiazem improved ATP-generating capacity during reperfusion by improving liver tissue blood flow. An improvement in hepatic tissue perfusion may be a therapeutic strategy for liver IR injury.

Animals↗

Dose calculation system for remotely supporting radiotherapy.

The dose calculation system IMAGINE is being developed keeping in mind remotely supporting external radiation therapy using photon beams. The system is expected to provide an accurate picture of the dose distribution in a patient body, using a Monte Carlo calculation that employs precise models of the patient body and irradiation head. The dose calculation will be performed utilising super-parallel computing at the dose calculation centre, which is equipped with the ITBL computer, and the calculated results will be transferred through a network. The system is intended to support the quality assurance of current, widely carried out radiotherapy and, further, to promote the prevalence of advanced radiotherapy. Prototypes of the modules constituting the system have already been constructed and used to obtain basic data that are necessary in order to decide on the concrete design of the system. The final system will be completed in 2007.

Body Burden↗

Comparison of the intubating laryngeal mask airway and laryngeal tube placement during manual in-line stabilisation of the neck.

We compared the placement of the laryngeal tube (LT) with the intubating laryngeal mask airway (ILMA) in 51 patients whose necks were stabilised by manual in-line traction. Following induction of anaesthesia and neuromuscular blockade, the LT and ILMA were inserted consecutively in a randomised, crossover design. Using pressure-controlled ventilation (20 cmH(2)O inspiratory pressure), we measured insertion attempts, time to establish positive-pressure ventilation, tidal volume, gastric insufflation, and minimum airway pressure at which gas leaked around the cuff. Data were compared using Wilcoxon signed-rank tests; p < 0.05 was considered significant. Insertion was found to be more difficult with the LT (successful at first attempt in 16 patients) than with the ILMA (successful at first attempt in 42 patients, p < 0.0001). Time required for insertion was longer for the LT (28 [23-35] s, median [interquartile range]) than for the ILMA (20 [15-25] s, p = 0.0009). Tidal volume was less for the LT (440 [290-670] ml) than for the ILMA (630 [440-750] ml, p = 0.013). Minimum airway pressure at which gas leak occurred and incidence of gastric insufflation were similar with two devices. In patients whose necks were stabilised with manual in-line traction, insertion of the ILMA was easier and quicker than insertion of the LT and tidal volume was greater with the ILMA than the LT.

Adult↗

Intubating laryngeal mask airway allows tracheal intubation when the cervical spine is immobilized by a rigid collar.

BACKGROUND: An intubating laryngeal mask airway (ILMA) facilitates tracheal intubation with the neck in neutral position, which is similar to the neck position maintained by a rigid cervical collar. However, a cervical collar virtually obliterates neck movement, even small movements that normally facilitate airway insertion. We therefore tested the hypothesis that the ILMA will allow tracheal intubation even in patients wearing a rigid cervical collar. METHODS: We performed blind tracheal intubation via an ILMA under general anaesthesia in 50 patients with a rigid Philadelphia collar in place undergoing cervical spine surgery and 50 general surgical patients. Time required for intubation, intubation success rate, and numbers and type of adjusting manoeuvres used were recorded. RESULTS: Inter-incisor distance was significantly smaller (4.1 (0.8) vs 4.6 (0.7) cm, mean (sd), P<0.01) and Mallampati scores were significantly greater (P<0.001) in the patients with collars. ILMA insertion took longer (30 (25) vs 22 (6) s), more patients required two insertion attempts (15 vs 3; P<0.005), and ventilation adequacy with ILMA was worse (P<0.05) in collared patients. However, there were no significant differences between the collars and control patients in terms of total time required for intubation (60 (41) vs 50 (30) s), number of intubation attempts, overall intubation success rate (96 vs 98%), or the incidence of intubation complications. CONCLUSIONS: Blind intubation through an ILMA is thus a reasonable strategy for controlling the airway in patients who are immobilized with a rigid cervical collar.

Adolescent↗

Centrosome hyperamplification and chromosomal damage after exposure to radiation.

OBJECTIVE: In order to elucidate the effects of radiation on centrosome hyperamplification (CH), we examined the centrosome duplication cycle in KK47 bladder cancer cells following irradiation. METHODS: KK47 cells were irradiated with various doses of radiation and were examined for CH immunostaining for gamma-tubulin. RESULTS: Nearly all control cells contained one or two centrosomes, and mitotic cells displayed typical bipolar spindles. The centrosome replication cycle is well regulated in KK47. Twenty-four hours after 5-Gy irradiation, approximately 80% of irradiated cells were arrested in G2 phase, and at 48 h after irradiation, 56.9% of cells contained more than two centrosomes. Laser scanning cytometry performed 48 h after irradiation showed the following two pathways: (1) unequal distribution of chromosomes to daughter cells, or (2) failure to undergo cytokinesis, resulting in polyploidy. With mitotic collection, M-phase cells with CH could be divided into G1 cells with micronuclei and polyploidal cells. Fluorescence in situ hybridization analysis showed clear signs of chromosomal instability (CIN) at 48 h after irradiation. The present study had two major findings: (1) continual duplication of centrosomes occurred in the cell cycle-arrested cells upon irradiation, leading to centrosome amplification; (2) cytokinesis failure was due to aberrant mitotic spindle formation caused by the presence of amplified centrosomes. Abnormal mitosis with amplified centrosomes was detected in the accumulating G2/M population after irradiation, showing that this amplification of centrosomes was not caused by failure to undergo cytokinesis, but rather that abnormal mitosis resulting from amplification of centrosomes leads to cytokinesis block. CONCLUSION: These results suggest that CH is a critical event leading to CIN following exposure to radiation.

Blotting, Western↗

Phosphorus removal under anoxic conditions in a continuous-flow A2N two-sludge process.

The Anaerobic-Anoxic/Nitrification (A2N) system is a continuous-flow, two-sludge process in which Poly-P bacteria are capable of taking up phosphate under anoxic conditions using nitrate as an electron acceptor. The process is very efficient because it maximizes the utilization of organic substrate for phosphorus and nitrogen removal. An experimental lab-scale A2N system fed with domestic sewage was tested over a period of 260 days. The purpose of the experiment was to examine phosphorus removal capacity of a modified A2N two-sludge system. Factors affecting phosphorus and nitrogen removal by the A2N system were investigated. These factors were the influent COD/TN ratio, Sludge Retention Time (SRT), Bypass Sludge Flow rate (BSF) and Return Sludge Flow rate (RSF). Results indicated that optimum conditions for phosphorus and nitrogen removal were the influent COD/TN ratio around 6.49, the SRT of 14 days, and the BSF and RSF were fixed at about 26-33% of influent flow rate.

Bacteria, Anaerobic↗

Differences in perioperative coagulation between Japanese and other ethnic groups undergoing laparoscopic cholecystectomy.

BACKGROUND: Japanese patients experience fewer episodes of postoperative thrombosis than those in certain other countries. To investigate this phenomenon, we measured perioperative coagulation activation markers and conducted thromboelastography (TEG) in 27 Japanese patients undergoing laparoscopic cholecystectomy. METHODS: D-dimer, thrombin-antithrombin complex (TAT), and prothrombin fragment 1+2 (F1+2) were measured as coagulation activation markers. TEG was performed to measure reaction time (R), clot formation time (K), maximum amplitude (MA), and maximum elastance (ME). These measurements were performed before and after the operation and the day after the operation. RESULTS: Coagulation activation markers increased significantly postoperatively. With respect to TEG, MA and ME increased postoperatively. R and K did not change. CONCLUSION: Whereas clotting factor activation sthenia is common in Europe and North America, thrombocyte function sthenia occurs in Japanese patients. This difference may account for the differing incidences of phlebothrombosis in Japanese and white populations.

Aged↗

Centrosome hyperamplification and chromosomal instability in bladder cancer.

OBJECTIVE: Chromosomal instability (CIN) is a common feature of malignant tumors. Centrosome hyperamplification (CH) occurs frequently in human cancers, and may be a contributing factor in CIN. In this study, we investigated the relationship between CH and CIN in bladder cancer. METHODS: Clinical samples obtained by transurethral resection from 22 patients with bladder cancer were examined (histological grade G1, 5 cases; G2, 6 cases; G3, 11 cases). CH was evaluated by immunohistochemistry using anti-pericentrin antibody. CIN was evaluated by fluorescence in situ hybridization (FISH). FISH probes for pericentromeric regions of chromosomes 3, 7, and 17 were hybridized to touch preparations of nuclei from frozen tissues. We also analyzed the centrosome replication cycle of bladder cancer by laser scanning cytometry (LSC). RESULTS: Of the 22 cases examined, 18 (81.8%) had centrosome hyperamplification: CH 0, 4 cases (18.1%); CH I, 5 cases (22.7%); CH II, 5 cases (22.7%); CH III, 8 cases (36.4%). The grade of CH was directly proportional to the histological grade (p=0.03, chi(2) test). LSC analysis showed that the centrosome replication cycle was well regulated in pathologically low-grade bladder cancer, which did not have chromosomal instability. In contrast, we found marked variability of centrosomes in pathologically high-grade bladder cancer, which had chromosomal instability. CH and CIN were both detected in pathologically high-grade tumors. The grade of CH was directly proportional to the CIN grade (p=0.0079, chi(2) test). CONCLUSION: The results of the present study suggest that CH may be involved in CIN in bladder cancer.

Aged↗

Inhibition of hypoxia/reoxygenation-induced oxidative stress in HGF-stimulated antiapoptotic signaling: role of PI3-K and Akt kinase upon rac1.

Rac1-regulated reactive oxygen species (ROS) production has been implicated in apoptosis. In contrast, pleiotropic protein kinase Akt protects against apoptosis. However, the pro- and antiapoptotic mechanisms of rac1 and Akt, respectively, and the intersection between these mechanisms are incompletely understood. In a model of oxidative stress and apoptosis induced by hypoxia/reoxygenation (H/R) in primary hepatocytes, activation of the PI3-K Akt axis by the prosurvival hepatocyte growth factor (HGF) inhibited H/R-stimulated rac1 activation and intracellular ROS production, and suppressed apoptosis. Suppression of PI3-K or Akt activity abrogated the inhibitory effect of HGF on rac1 activity and rac1-regulated oxidative stress. Furthermore, constitutive activation of Akt or PI3-K in the absence of HGF was sufficient to phosphorylate rac1, inhibit rac1 activation, and suppress rac1-regulated ROS production. These findings demonstrate that growth factor-stimulated activation of PI3-K-Akt is necessary and sufficient to suppress intracellular oxidative stress and apoptosis by inhibiting activation of pro-apoptotic, prooxidative rac1 GTPase.

Androstadienes↗

Actions of domperidone on the opioid system in isolated guinea-pig ileum: differences between dopamine antagonists on opioid system.

1. To validate the relationship between the dopaminergic, opioidergic and cholinergic nervous systems, we evaluated the effect of domperidone, a dopamine (D2) antagonist, on the opioid system in myenteric plexus-longitudinal muscle preparation isolated from the guinea-pig ileum. 2. One micromolar of domperidone did not affect the 0.1 Hz-evoked (duration 0.5 ms, maximum intensity) twitch response, but concentration dependently inhibited the twitch response between concentrations of 2 and 20 microM, and the inhibition was maximum after 20-30 min at the highest concentration used (20 microM). 3. Acetylcholine-evoked contraction on basal tension was also not inhibited by 1 microM domperidone, but the contraction was concentration dependently inhibited at concentrations of 10-100 microM in a non-competitive manner. 4. One micromolar of domperidone, however, increased post-tetanic twitch inhibition, an indicator of the release of endogenous opioids. This increase was completely antagonized by 1 microM naloxone. Twitch inhibition induced by dynorphin 1-13 (0.1-10 nM) was not affected by 1 microM domperidone, but increased the maximum twitch inhibition caused by morphine (0.1-1 microM). 6. These results might reflect the existence of an interaction between the dopaminergic and opioidergic system without the inhibition of the cholinergic system. Dopamine antagonists increased opioid action, an action that may depend more on the increased release of endogenous opioids than on supersensitivity of the opioid receptor.

Animals↗

Nitrous oxide decreases shivering threshold in rabbits less than isoflurane.

BACKGROUND: Comparable minimum alveolar concentration (MAC) fractions of volatile anaesthetics produce similar thermoregulatory impairment. Nitrous oxide, however, decreases the vasoconstriction threshold less than sevoflurane or isoflurane. We tested the hypothesis that nitrous oxide also decreases shivering threshold less than isoflurane alone or in combination. METHODS: Twenty-four rabbits were assigned randomly to one of three 0.3 MAC anaesthetic regimens: (i) nitrous oxide 69%; (ii) nitrous oxide 35% and isoflurane 0.3%; or (iii) isoflurane 0.6%. Body temperature was lowered by perfusing 10 degrees C water through a U-shaped thermode positioned in the colon. Shivering was evaluated by inspection. RESULTS: The rabbits anaesthetized with nitrous oxide alone shivered at 37.0 (0.5) degrees C (P<0.01 vs other groups). In those given the nitrous oxide and isoflurane combination, the shivering threshold was 36.4 (0.5) degrees C and that in the isoflurane group was 35.9 (0.4) degrees C. CONCLUSION: This study indicates that nitrous oxide reduces the shivering threshold less than isoflurane.

Anesthetics, Inhalation↗

Enhanced insulin gene expression by reduced intracellular glutathione level in insulin secreting cells MIN6.

Glutathione (GSH) participates in deoxidization and elimination of hydrogen peroxide and other reactive oxygen species, and plays an important part in the antioxidant system. To investigate the effect of GSH content on insulin gene expression, we utilized a stable transfectant, designated as ribo-MIN6 cells, which were stably transfected with the ribozyme of gamma-glutamylcysteine synthetase (gamma-GCS), exhibiting approximately 50% reduction of intracellular GSH content. We transiently transfected a luciferase expression vector driven by human preproinsulin gene promoter spanning from -1998 to +237 (pINS-1998/luc) and several deletion constructs into ribo-MIN6. Furthermore, transient transfection with ribozyme vector and pINS-1998/luc into wild-type MIN6 cells was also carried out. Luciferase activity was about 9-fold higher in ribo-MIN6 cells as compared to wild-type MIN6 cells. In the transient transfection of pINS-1998/luc with gamma-GCS ribozyme vector into wild-type MIN6 cells, the luciferase activity was increased in proportion to the added amounts of ribozyme vector. In transfection with deletion constructs, two major sites were found to be critical for insulin promoter activity. For the wild-type MIN6 cells, regions important for the promoter activity were also located at regions similar to those of ribo-MIN6 cells. Our results suggest that the suppression of intracellular GSH level might, in part, regulate the insulin gene expression.

Animals↗

Non-filamentous sludge bulking caused by a deficiency of nitrogen in industrial wastewater treatment.

Deficiency in the nutrient supply such as nitrogen usually results in activated sludge bulking and this phenomenon often takes place in the industrial wastewater treatment plants with activated sludge process. The effects of nitrogen deficiency on activated sludge bulking were studied specially in some experiments carried out in a sequencing batch reactor fed with brewing process wastewater in this paper. The experimental results showed that the sludge settled properly at an influent BOD/N value of 100/4. When the value of BOD/N was 100/3, filaments had an excessive growth at one time during the reaction process. Afterwards, the number of filamentous bacteria began to reduce and simultaneously an excessive growth of viscous Zoogloea with high percentage of moisture was observed and non-filamentous activated sludge bulking occurred. When the influent BOD/N value was 100/2, the excessive growth of filamentous microorganisms could not be observed at all times and the sludge characterization was similar to the case in which BOD/N value was 100/3. When the value of influent BOD/N was 100/0.94, more serious non-filamentous bulking occurred. Furthermore, the effects of nitrogen deficiency on the nitrogen sources and phosphorus sources utilization rate and the COD removal rate were investigated in the experiments.

Beer↗