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Biomedical subjects

M Sakuma

Publications and source records attributed to M Sakuma.

At least 37 records · Page 2Linked to original sources
PubMed1999

Atherosclerotic superficial temporal artery aneurysm: report of a case.

We herein report a rare case of an atherosclerotic superficial temporal artery (STA) aneurysm. The patient was a 34-year-old Japanese man. He noticed a throbbing swelling just in front of his right ear, which had slowly increased in size. There was no history of trauma. Digital subtraction angiography and ultrasound revealed an aneurysm measuring 2cm in diameter fed by STA. A ligation and resection were performed under local anesthesia. The recovery period was uneventful. A microscopic examination revealed a moderate degree of atherosclerosis. We found 48 cases of STA aneurysm in the Japanese literature from 1969 to 1997, including our case. Thirty-six of these cases (75.0%) were considered to be traumatic in origin. Three cases (6.2%) occurred after a craniotomy. To date, only nine reported cases (18.8%) have been attributed to a spontaneous or congenital etiology.

Adult↗
PubMed1999

Current trends in thromboangiitis obliterans (Buerger's disease) in women.

BACKGROUND AND PURPOSE: Thromboangiitis obliterans (TAO) affects mainly young male smokers and rarely women. Clinical manifestations between men and women with TAO were compared based on the Japanese Nationwide Survey database. PATIENTS AND METHODS: From the database registered in 1993, 850 patients with complete records were analyzed. There were 771 males and 79 females, with the mean age of 50.8 +/- 0.4 years. The following factors were compared: Fontaine's classification, distribution of lesions, associated disease, response to treatment, and outcome. RESULTS: Fontaine's classification at the first consultation (P = 0.372) and at the survey (P = 0.740), the incidence of migratory superficial phlebitis (P = 0.76), ulcer formation (P = 0.306), requirement for amputation (P = 0.809) were not different between men and women. Nonsmokers at the first consultation were more common among women (25.3%) than among men (4.9%; P <0.0001). CONCLUSIONS: Clinical presentations in women with TAO were almost equal to those in men. The only difference was the higher incidence of nonsmokers in women at the first consultation, but it did not influence the response to treatment or outcome.

Adolescent↗
PubMed1999

Gene structure and amino acid sequence of Latimeria chalumnae (coelacanth) myelin DM20: phylogenetic relation of the fish.

The structure of Latimeria chalumnae (coelacanth) proteolipid protein/DM20 gene excluding exon 1 was determined, and the amino acid sequence of Latimeria DM20 corresponding to exons 2-7 was deduced. The nucleotide sequence of exon 3 suggests that only DM20 isoform is expressed in Latimeria. The structure of proteolipid protein/DM20 gene is well preserved among human, dog, mouse, and Latimeria. Southern blot analysis indicates that Latimeria DM20 gene is a single-copy gene. When the amino acid sequences of DM20 were compared among various species, Latimeria was more similar to tetrapods than other fishes including lungfish, confirming the previous finding by immunoreactivity (Waehneldt and Malotka 1989 J. Neurochem. 52:1941-1943). However, when phylogenetic trees were constructed from the DM20 sequences, lungfish was clearly the closest to tetrapods. Latimeria was situated outside of lungfish by the maximum likelihood method. The apparent similarity of Latimeria DM20 to tetrapod proteolipid protein/DM20 is explained by the slow amino acid substitution rate of Latimeria DM20.

Amino Acid Sequence↗
PubMed1999

Expression of a src-type protein tyrosine kinase gene, AcSrc1, in the sea urchin embryo.

By screening a cDNA library and 3'-rapid amplification of cDNA ends, the cDNA for a non-receptor type protein tyrosine kinase from the sea urchin Anthocidaris crassispina was analyzed. The deduced protein (AcSrc1) with the highest identity of about 60% to mammalian Src family kinases shows the characteristic features of the Src family. AcSrc1 mRNA is maternally expressed in unfertilized eggs, while zygotic expression is first detected in blastulae and continues through the pluteus stage. Zygotic mRNA expression, visualized by in situ hybridization, is detected specifically in archenteron at the gastrula stage, while it is restricted in plutei to the midgut and hindgut, suggesting specific roles for AcSrcl in the formation and/or functions of the digestive tract. Meanwhile, western blot analysis has shown that the AcSrc1 protein is constantly expressed throughout embryogenesis. By immunostaining, it was found that the protein (distributed evenly in the cytoplasm of unfertilized eggs) is translocated to the membrane after fertilization. All through the following development, AcSrcl was localized to the peripheries of different embryonic cells, although at a relatively low level of localization at the boundaries between adjacent cells.

Amino Acid Sequence↗
PubMed1999

Infectious etiology of xanthogranulomatous cholecystitis: immunohistochemical identification of bacterial antigens in the xanthogranulomatous lesions.

The clinicopathologic features of 31 surgical patients with xanthogranulomatous cholecystitis were analysed in relation to the immunohistochemical demonstration of bacterial antigens using a polyclonal anti-E. coli antibody. The time period after the initial clinical manifestation was critical for identifying the bacterial antigens in the cytoplasm of foamy macrophages. Of 12 lesions removed within 4 weeks of the onset (subacute group), 7 lesions showed positive staining. No positivity was seen in 19 gall-bladder specimens with a clinical course of more than 4 weeks (chronic group). Abscess formation was seen in 7 cases in the subacute group, 5 of which were positive for the bacterial antigens. Gram-negative bacteria were cultured from the bile in four in the subacute group and three in the chronic group. All the four culture-positive subacute lesions were immunoreactive for the bacterial antigens. Accumulation of ceroid pigment in the cytoplasm of foamy macrophages was characteristically seen in 16 of 20 chronic lesions. Three subacute lesions with ceroid pigmentation was negative for the bacterial antigens. In conclusion, xanthogranulomatous cholecystitis can be divided into two forms: subacute and chronic, and the subacute form is closely related to bacterial infection.

Adolescent↗
PubMed1999

Longitudinal neuropsychological follow-up study of patients with first-episode schizophrenia.

OBJECTIVE: The primary purpose of this article was to determine if cognitive abilities decline, remain unchanged, or modestly improve throughout the course of schizophrenic illness. METHOD: Forty-two patients with a first hospitalization for schizophrenia or schizophreniform disorder and 16 normal comparison subjects had a battery of neuropsychological tests and a magnetic resonance imaging (MRI) brain scan at approximate yearly intervals for the first 2 to 5 years of illness. Summary rating scales for language, executive, memory, processing speed, and sensory-perceptual functions were constructed. RESULTS: Patients with schizophrenia scored 1 to 2 standard deviations below normal comparison subjects on neuropsychological test measures during the course of the study. Patients exhibited less improvement than comparison subjects on measures of verbal memory. In general, improvement in positive symptoms over the time interval was associated with improvement in cognition. No changes in regional brain measurements were correlated with cognitive change in the patient group. CONCLUSIONS: Patients with schizophrenia have considerable cognitive dysfunction in the first 4 to 5 years of illness, which is stable at a level of 1 to 2 standard deviations below that of comparison subjects. There is little evidence for deterioration of cognitive abilities over the first few years of illness, with the exception of verbal memory, which shows significantly less improvement in patients over time relative to that of comparison subjects.

Adult↗
PubMed1999

Reduction of the parahippocampal gyrus and the hippocampus in patients with chronic schizophrenia.

BACKGROUND: There have been many studies reporting reduced volume of the hippocampus or other limbic structures in patients with schizophrenia, but the literature is inconsistent. AIMS: To compare patients with either first-episode or chronic schizophrenia with controls using high-resolution volumetric magnetic resonance imaging (MRI) scans. METHOD: Thirteen patients with first-episode schizophrenia, 27 with chronic schizophrenia and 31 controls had 1.5 mm coronal slices taken through the whole brain using a spoiled-grass MRI acquisition protocol. RESULTS: The parahippocampal gyrus was reduced significantly on the left side in patients with chronic schizophrenia compared with controls for both male and female patients, whereas the hippocampus was reduced significantly on both sides only in female patients. There were no significant reductions in any structure between patients with first-episode schizophrenia and controls. CONCLUSIONS: Volumetric reduction seen in patients with chronic schizophrenia may be due to an active degenerative process occurring after the onset of illness.

Adult↗
PubMed1999

Incidence of pulmonary thromboembolism in Japan.

Pulmonary thromboembolism (PTE) is considered an uncommon disease in Japan and there are not any reported prospective studies on the incidence of PTE in Japan. The objective of the present study was to determine the number of patients with PTE per year in a prospective study using a questionnaire. Letters were sent to clinical departments in university schools of medicine or medical colleges, and to hospitals with more than 100 beds. The diagnosis of PTE was to be confirmed by (1) pulmonary artery stenosis or occlusion on pulmonary angiography, (2) mismatch of pulmonary perfusion scintigraphy and pulmonary ventilation scintigraphy, (3) changes on pulmonary perfusion scintigraphy performed twice, or (4) autopsy. The questionnaire elicited 2,341 replies (the withdrawal rate was 40.7%). In 231 hospitals, 237 patients were diagnosed definitely during the study period of 2 months from 1 August to 30 September 1996. From this it was estimated that there are 3,492 (95% confidence interval: 3,280-3,703) patients with PTE per year, which implies that the incidence is 28 persons per 1,000,000 people per year, confirming that PTE is rare in Japan.

Adult↗
PubMed1999

[Long-term results of mitral valve regurgitation after surgical repair of incomplete atrioventricular septal defect].

Although the postoperative outcome in patients with incomplete atrioventricular septal defect (iAVSD) is excellent, deterioration of mitral valve regurgitation (MR) is still remained to be resolved. Therefore, this study was undertaken to compare surgical procedures for mitral cleft repair with their long-term results of MR. From 1991 to 1996, 52 patients underwent surgical repair of iAVSD. Age at operation ranged from 2 months to 62 years old with mean age of 14.2 years. Mean follow-up period was 8.6 +/- 4.4 years. All patients underwent patch closure of ostium primum defect. Two patients did not have cleft (Group A). Seven patients did not close the cleft at all (Group B), while 40 patients had the repair of valve by closing cleft near septal attachment only (Group C). The latest 3 patients had the complete closure of cleft from annulus to margin of leaflet where chorda is attached. MR was evaluated by echocardiography grading 0 to IV and regurgitation more than grade II was considered to be significant. In Group A, MR remained grade I. In Group B, MR was deteriorated in 5 patients (71%). Consequently, 6 patients (86%) had grade II or more regurgitation and 4 patients (57%) revealed grade III/IV regurgitation including one (14%) reoperation. In Group C, MR was deteriorated in 10 patients (55%). Consequently, 22 patients (86%) had grade II or more regurgitation and 5 patients (13%) had grade III/IV regurgitation including 3 (7.5%) reoperations. In Group D, no deterioration of MR was noted and all had grade I or less regurgitation. These results suggest that the closure of cleft near septal attachment is not sufficient to prevent MR in late phase and the complete closure of cleft from annulus to margin of leaflet, where chorda is attached, would be useful to prevent the deterioration of MR in late phase.

Adolescent↗
PubMed1999

Ruptured abdominal aortic aneurysms: analysis of factors influencing surgical results in 184 patients.

BACKGROUND: Rupture is often the first manifestation in patients with abdominal aortic aneurysms. Although elective surgery for non-ruptured abdominal aortic aneurysms has provided satisfactory surgical results, operative mortality of ruptured abdominal aortic aneurysms (rAAA) has not improved. The purpose of this study was to identify predictors for early hospital death in patients with rAAA. METHODS DESIGN: A retrospective study. SETTING: A university hospital and 20 affiliated hospitals. PATIENTS: PATIENTS undergoing surgical treatment for rAAA (n=183) between 1968 and 1997. INTERVENTIONS: All patients were surgically treated and divided into operative survivors (n=119) and non-survivors (n=64). MEASURES: The patient-related, procedure-related, and postoperative factors were compared between the two groups. A multivariate analysis was also conducted to determine predictors for hospital deaths. RESULTS: In univariate analysis, age at operation (p=0.004), preoperative hemodynamic conditions (p<0.0001), extent of hematoma (p<0.0001), preexistent renal dysfunction (p=0.001), and volumes of blood loss at operation (p=0.001) were significantly different between the two groups. The morbidity of postoperative renal failure (p<0.0001), gut ischemia (p=0.003), heart failure or ischemic heart disease (p<0.0001), and multiple organ dysfunction syndrome (p<0.0001) was higher in the non-survivors' group. Multivariate analysis also identified preoperative hemodynamic conditions, blood loss volume at operation, pre-existent renal dysfunction, postoperative renal failure, heart failure, and multiple organ dysfunction syndrome as incremental risk factors for hospital deaths. CONCLUSIONS: Every effort to maintain preoperative hemodynamic conditions, to reduce volumes of blood loss at operation, and to minimize deterioration of organ functions postoperatively is all essential to improve patient survival.

Adult↗
PubMed1999

[A case of progressive systemic sclerosis complicated by idiopathic portal hypertension with severe anemia].

A 44-year-old woman had been diagnosed with progressive systemic sclerosis (PSS) at the age of 39 years old and mild pancytopenia was noted at that time. At the age of 41 years symptoms of dry mouth appeared. In April 1997, anemia was in progress (Hb 5.8 g/dl) and severe esophageal varices were found by gastrointestinal fiber scope, and massive splenomegaly by abdominal CT. Serological examination was negative for hepatitis virus and for anti-mitochondrial antibody. In addition, Indocyanine Green test was normal and typical findings of liver cirrhosis were not demonstrated by CT scan. Also, the bone marrow result was normal. Therefore hypersplenism with idiopathic portal hypertension (IPH) was suggested and the patient was referred for splenectomy with the aim of improving the pancytopenia. The weight of the spleen was 2100 g and the pressure of the portal vein was measured at 390 mm H2O. The diagnosis of IPH was determined because pathologically there were no findings for liver cirrhosis. After splenectomy, pancytopenia was remarkably improved (Hb 9.6 g/dl). Consequently, this case was diagnosed as IPH complicated with PSS and Sjögren syndrome.

Adult↗
PubMed1998

Association of brain structural change with the heterogeneous course of schizophrenia from early childhood through five years subsequent to a first hospitalization.

Fifty first-episode patients with schizophrenia were followed for 5 years subsequent to their first hospitalization. The course of illness was charted prospectively and premorbid childhood histories were obtained retrospectively at the initial evaluation, and MRI scans were obtained initially and at each follow-up. Fifteen different life-time patterns of illness course emerged, although none were specifically associated with structural brain change. A deterioration in premorbid scores was positively correlated with larger ventricular volume at the first hospitalization, and the larger the ventricles, the less the subsequent change in ventricular size thereafter. An analysis to see whether initial hemispheric and ventricular size could predict different course types only revealed that patients with an acute onset and complete recovery had significantly smaller ventricles than all others. No differences emerged for initial hemispheric size. Thirty-four percent of patients individually showed some association of brain ventricular size and 28% hemisphere volume reductions with fluctuation in psychotic symptoms. Paradoxically, most showed larger ventricles and smaller hemispheres to be associated with clinical improvement, rather than the predicted reverse. These latter data question the notion that the structural brain changes seen over time in some patients are related to poor outcome, although small ventricular size in those patients with acute onset may be predictive of recovery. Thus, brain structural change is occurring early in the course of illness and may be a consequence of the process leading to resolution.

Adolescent↗
PubMed1998

Arg506Gln mutation of the coagulation factor V gene not detected in Japanese pulmonary thromboembolism.

The incidence of pulmonary thromboembolism (PTE) is lower in Japanese than in Caucasians. The basis for the different incidence has not been clarified. A poor anticoagulant response to activated protein C based on a single point mutation of the factor V gene (Arg506Gln) was found to be a pathogenetic factor for venous thrombosis and PTE in North America and Europe. We investigated whether the Arg506Gln mutation of factor V is responsible for the occurrence of PTE among Japanese. We analyzed genomic DNA prepared from fresh peripheral blood of 25 patients with PTE of unknown etiology (12 of acute type and 13 of chronic type) and that of 110 controls without respiratory or circulatory disorders. To detect the Arg506Gln mutation, 267 bp DNA fragments of the factor V gene including the Arg506Gln region were amplified by PCR, digested by MnlI and electrophoresed. After digestion of PCR products with MnlI, DNA fragments of 163 bp length, but not DNA fragments of 200 bp length, were identified in all samples, indicating the absence of the Arg506Gln mutation in the patients with PTE and control subjects. These results suggest that the Arg506Gln mutation is absent or very rare and not an important pathogenetic factor for PTE in Japanese.

Aged↗
PubMed1998

Determinants of postoperative and long-term survival of patients with ruptured abdominal aortic aneurysms.

To compare the surgical results of patients with ruptured (rAAA) and nonruptured abdominal aortic aneurysms (NrAAA), 267 consecutive patients surgically treated for abdominal aortic aneurysms (AAA) were reviewed. The patients' characteristics, preexistent risk factors, perioperative factors, and postoperative early and long-term survival were compared between the rAAA group (n = 27) and the NrAAA group (n = 240). A multivariate analysis to predict postoperative survival was also conducted in the rAAA group. The hospital mortality rate was 3.3% (8/232) for the NrAAA group and 22.2% (6/27) for the rAAA group (P < 0.001). The maximum size of aneurysms, period of preoperative hypotension, and intraoperative bleeding volume were significantly higher in the rAAA group than in the NrAAA group. The 5- and 10-year cumulative survival rates in the rAAA group were 88.1% and 42.0%, which were comparable to those in the NrAAA group. The incremental risk factors for hospital death in the rAAA group included advanced age, preoperative hypotension (< 80 mmHg), and postoperative renal failure requiring dialysis. These findings showed that the interval from rupture to cross-clamping must be shortened, maintaining hemodynamic stability to avoid prolonged hypotension. Reducing risk factors and minimizing deterioration of organ functions postoperatively would be essential to improve the prognosis of patients with rAAA.

Aged↗
PubMed1998

Simultaneous dorsal dislocation of the metacarpophalangeal and carpometacarpal joints of a finger.

A case of simultaneous dorsal dislocation of the metacarpophalangeal (MP) and carpometacarpal (CMC) joints in the little finger is presented. The patient required a second surgical intervention for volar subluxation of the MP joint which occurred while wearing a dorsal splint following open reduction of the MP joint and closed reduction of the CMC joint. Two years postoperatively, the patient was asymptomatic but was left with mild stiffness of the MP joint.

Adult↗
PubMed1998

Purification and some properties of a hepatic NADPH-dependent reductase that specifically acts on 1,5-anhydro-D-fructose.

Glycogen gives rise to 1,5-anhydro-D-fructose (AF), which is then reduced to 1,5-anhydro-D-glucitol (AG) in animal livers. An enzyme that catalyzes NADPH-dependent reduction of AF to AG was isolated and purified to homogeneity from porcine liver. Its apparent molecular mass was about 38 kDa on the basis of SDS-PAGE, and its monomeric dispersion in aqueous solution was indicated by gel filtration on a Superose 12 column. Amino acid sequences were determined for four peptides obtained from the purified enzyme. The resulting sequences covered about 50% of the whole sequence and indicated a remarkable similarity between the enzyme and aldose reductase. The purified enzyme showed molecular activity of 8.7 s(-1) on the basis of a molecular mass of 38 kDa, and a Km value of 0.44 mM for AF at the optimum pH of 7.0. It reduced pyridine-3-aldehyde and 2,3-butanedione effectively, acetaldehyde, glucosone, and glucuronic acid poorly and showed no detectable action on glucose, mannose and fructose. It was inactivated by p-chloromercuribenzoic acid to a considerable extent, and the inactivation was partially reversed by 2-mercaptoethanol treatment. It was also sparingly inhibited by relatively high concentrations of glucose, glucose-1(6)-phosphate and 1,5-anhydroglucitol. The reverse reaction, i.e., NADP+-dependent AG oxidation, was not observed. The observed catalytic properties and partial amino acid sequences rule out the possibility that the isolated protein is identical with any known reductase.

Amino Acid Sequence↗
PubMed1998

Sex differences in neuropsychological functioning of first-episode and chronically ill schizophrenic patients.

OBJECTIVE: The purpose of this study was to determine whether men and women with schizophrenia demonstrate differences in cognitive abilities. METHOD: Two cohorts of patients with schizophrenia, an acute first-episode and a chronically hospitalized group, were evaluated with a neuropsychological battery and compared with a normal group of subjects. RESULTS: After adjustment for age, age at onset, and premorbid IQ, male chronic patients performed worse than female chronic patients on measures of visual memory. These differences were eliminated after control for symptom severity. No other differences were found in cognitive function between men and women in either cohort. CONCLUSIONS: Sex differences in cognitive function in schizophrenic patients are not robust findings.

Age of Onset↗