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R Fujita

Publications and source records attributed to R Fujita.

At least 109 records · Page 6Linked to original sources

[Changes in granulocyte elastase caused by the use of ulinastatin during anesthesia for renal transplantation].

In patients with renal failure, releases of chemical mediators having inhibitory influences on organs and circulatory system have been observed. Therefore, in long-term dialysis patients, it is necessary to consider the biocompatibilities of the equipment for dialysis. On 13 cases of renal transplantations, we measured the pre- and post-operative changes of granulocyte elastase (GE) and evaluated the effect of ulinastatin. The renal transplanted patients receiving a long-term dialysis showed higher GE values than that of normal patients even before the operation. During the anesthesia, GE increased gradually and further increased after the operation. In patients given ulinastatin during anesthesia, the increase in GE during the operation was suppressed but an increase after the operation was observed. The renal transplanted patients are easily infectible. Therefore, it is useful to measure GE pre- and post-operatively for earlier diagnosis of the postoperative infection and septicemia. The administration of ulinastatin can inhibit the increase of GE. It seems that ulinastatin increases renal blood flow and improves renal function.

Adult↗

[A comparison of induced hypotensive anesthesia using trimetaphan, prostaglandin E1 and nicardipine for neurosurgery].

We performed hypotensive anesthesia using trimetaphan, prostaglandin E1, or nicardipine for eighteen patients undergoing cerebral aneurysm clipping. We measured the hemodynamic parameters (systolic arterial pressure, diastolic arterial pressure, and heart rates), concentration of catecholamines in blood (epinephrine, norepinephrine), blood platelet counts, and aggregation of blood platelets, before induction of anesthesia, before induced hypotension, during hypotension, after hypotension, and at the end of operation. Hypotension was produced rapidly, and hemodynamics was stable with any of the three drugs. In trimetaphan group, however, recovery time of arterial pressure was longer than in other two groups. There was no significant change of catecholamine during induced hypotension in prostaglandin E1 and nicardipine groups. However, in trimetaphan group, concentration of norepinephrine in blood decreased significantly during hypotension. No significant change was observed in either platelet count or platelet aggregation. These results suggest that trimetaphan has an effect to suppress excretion of stress hormones, and prostaglandin E1 and nicardipine have no influence on blood catecholamine levels and aggregation of platelet. We consider that nicardipine is useful as a hypotensive drug for neurosurgery.

Alprostadil↗

Long-term follow-up of a paediatric case of lipoprotein glomerulopathy.

A paediatric case of lipoprotein glomerulopathy, a new kidney disease characterized by glomerular lipoprotein thrombi, is reported. The patient had massive proteinuria from the age of 8 years, when the nephrotic syndrome was first detected. This was resistant to conventional treatment for more than 10 years. During the course of the disease, the hyperlipidaemia characteristic of hyper-pre-beta-lipoproteinaemia and elevation of apoprotein E persisted, and renal function gradually deteriorated. The renal histopathological findings from four biopsies were essentially the same, with storage of beta-lipoprotein in dilated, balloon-like glomerular capillary lumina. However, the number of glomeruli showing global sclerosis increased and tubulo-interstitial changes progressed in parallel with the gradual clinical deterioration. As in other cases reported in Japan some familial involvement has been noted.

Apolipoproteins E↗

Additional polymorphisms at marker loci D9S5 and D9S15 generate extended haplotypes in linkage disequilibrium with Friedreich ataxia.

The gene for Friedreich ataxia (FA), a severe recessive neurodegenerative disease, has previously been shown to be tightly linked to the polymorphic markers D9S15 and D9S5 on human chromosome 9. In addition, the observation of linkage disequilibrium suggested that D9S15 is within 1 centimorgan (cM) of the disease locus, FRDA. Although D9S5 did not show recombination with FRDA, its localization was less precise (0-5 cM) due to its lower informativeness. We have now identified additional polymorphisms at both marker loci. Two cosmids spanning 50 kilobases around D9S5 were isolated, and a probe derived from one of them detects an informative three-allele polymorphism. We have found a highly polymorphic microsatellite sequence at D9S15 which is rapidly typed by the DNA polymerase chain reaction. The polymorphism information contents at the D9S5 and D9S15 loci have been increased from 0.14 to 0.60 and from 0.33 to 0.74, respectively. With the additional polymorphisms the lod (log10 odds ratio) score for the D9S15-FRDA linkage is now 48.10 at recombination fraction theta = 0.005 and for D9S5-FRDA, the lod score is 27.87 at theta = 0.00. We have identified a recombinant between D9S15 and FRDA. However, due to the family structure, it will be of limited usefulness for more precise localization of FRDA. The linkage disequilibrium previously observed between D9S15 and FRDA is strengthened by analysis of the haplotypes using the microsatellite polymorphism, while weaker but significant disequilibrium is found between D9S5 and FRDA. Extended haplotypes that encompass D9S5 and D9S15 show a strikingly different distribution between chromosomes that carry the FA mutation and normal chromosomes. This suggests that both marker loci are less than 1 cM from the FRDA gene and that a small number of mutations account for the majority of FA cases in the French population studied. D9S5 and D9S15 are thus excellent start points to isolate the disease gene.

Cell Line↗

[Use of vecuronium bromide for anesthesia for renal transplantation].

We used vecuronium on 7 patients for renal transplants and recorded the muscle relaxant effect using an Anesthesia and Brain Monitor; we also compared them with patients with normal renal function. Results show that there were no significant differences between renal transplant patients and patients with normal renal functions in regard to the time of appearance of effect, duration of effect and recovery rate but the effect was somewhat prolonged in the renal transplant patients. Therefore, although vecuronium is said to be a muscle relaxant with little renal dependency, and it is used on renal transplant patients with renal insufficiency, the possibility of a prolonged effect must be considered. It is important to monitor continuously by a muscle relaxant monitor, grasp adequately the conditions of muscle relaxation, and observe carefully the postoperative respiratory conditions.

Adult↗

The Friedreich ataxia gene is assigned to chromosome 9q13-q21 by mapping of tightly linked markers and shows linkage disequilibrium with D9S15.

Chamberlain et al. have assigned the gene for Friedreich ataxia (FA), a recessive neurodegenerative disorder, to chromosome 9, and have proposed a regional localization in the proximal short arm (9p22-cen), on the basis of linkage to D9S15 and to interferon-beta (IFNB), the latter being localized in 9p22. We confirmed more recently the close linkage to D9S15 in another set of families but found much looser linkage to IFNB. We also reported another closely linked marker, D9S5. Additional families have now been studied, and our updated lod scores are z = 14.30 at theta = .00 for D9S15-FA linkage and z = 6.30 at theta = .00 for D9S5-FA linkage. Together with the recent data of Chamberlain et al., this shows that D9S15 is very likely within 1 cM of the FA locus. We have found very significant linkage disequilibrium (delta Std = .28, chi 2 = 9.71, P less than .01) between FA and the D9S15 MspI RFLP in French families, which further supports the very close proximity of these two loci. No recombination between D9S5 and D9S15 was found in the FA families or Centre d'Etude du Polymorphisme Humain families (z = 9.30 at theta = .00). Thus D9S5, D9S15, and FA define a cluster of tightly linked loci. We have mapped D9S5 by in situ hybridization to 9q13-q21, and, accordingly, we assign the D9S5, D9S15, and FA cluster to the proximal part of chromosome 9 long arm, close to the heterochromatic region.

Alleles↗

Friedreich ataxia in Italian families: genetic homogeneity and linkage disequilibrium with the marker loci D9S5 and D9S15.

Friedreich ataxia (FA) is an autosomal recessive degenerative disease of the nervous system of unknown biochemical cause. The FA gene has been shown to be in close linkage with the two chromosome 9 markers D9S5 and D9S15, and linkage disequilibrium between FA and D9S15 has been detected in French families by Hanauer et al. We used new highly informative markers at the above loci to analyze Italian FA families for linkage and linkage disequilibrium. The new markers were a three-allele BstXI RFLP at D9S5 (PIC = .55) and a six-allele microsatellite, typed by polymerase chain reaction, at D9S15 (PIC = .75). We obtained maximum lod scores of 8.25 between FA and D9S5, 10.55 between FA and D9S15, and 9.52 between D9S5 and D9S15, all at zero recombination. Our results, combined with those reported by other authors, reduce maxlod-1 (maximum lod score minus 1) confidence limits to less than 1.1 cM between FA and D9S5, 1.2 cM between FA and D9S15, and 1.4 cM between D9S5 and D9S15. Linkage disequilibrium with FA was found only for D9S15 when all families were evaluated but was also found for a D9S5/D9S15 haplotype in a subgroup of southern Italian families. We conclude that FA, D9S5, and D9S15 are tightly clustered and that studies of geographically restricted groups may reveal a limited number of mutations responsible for the disease in the Italian population. We present preliminary evidence from pulsed-field gel electrophoresis that D9S5 and D9S15 may be less than 450 kb apart. Linkage disequilibrium between FA and D9S15 suggests that the disease gene may be at an even shorter distance from this marker locus, which therefore represents a very good starting point for cloning attempts.

Alleles↗

Confirmation of linkage of Friedreich ataxia to chromosome 9 and identification of a new closely linked marker.

A linkage analysis with chromosome 9 markers was performed in 33 families with Friedreich ataxia (FA). Linkage with D9S15, previously established by S. Chamberlain et al. (1988, Nature London 334:248-249) was confirmed in our sample (z(theta) = 6.82 at theta = 0.02) while INFB (interferon-beta gene) shows looser linkage. An additional marker, D9S5, was also shown to be closely linked to FA (z(theta) = 5.77 at theta = 0.00).

Chromosomes, Human, Pair 9↗

Peroral cholecystoscopy.

Three cases of peroral cholecystoscopy was reported. Dilatation of the cystic duct ranged from 8.5 mm to 10.0 mm in diameter, permitting passage of a 4.5 mm diameter baby 'scope. Endoscopic lithotripsy was performed without difficulty.

Cystic Duct↗

[Hemodynamic changes before and after anesthesia for renal transplantation].

Renal transplantation has come into use as a treatment for renal insufficiency, but infusion management before and after anesthesia for this operation is important. In order to prevent acute necrosis of the uriniferous tubules and to obtain urine outflow in early postoperative stage, a recent practice has been to give rapid infusions of large amounts of fluid, starting during the anastomosis of the renal vessels. We gave a large amount of intraoperative fluid to six patients undergoing transplantation of cadaver kidneys. A Swan-Ganz catheter was inserted into the pulmonary artery and infusion management was performed so as to maintain the pulmonary arterial pressure above 15 mmHg and the pulmonary capillary wedge pressure above 10 mmHg. The cardiac output increased as a result, and no pulmonary edema was seen. We believe that our method of infusion management using a Swan-Ganz catheter is a useful technique in such cases.

Adult↗

[Changes in catecholamine and immunoglobulin during anesthesia for cardiac surgery--a comparison of valve replacement and aorto-coronary bypass surgery].

During a period of extracorporeal circulation, which represents a massive invasion for the body, the patient is in a state of controlled shock. In this study, we examined changes in catecholamines and immunoglobulins in patients grouped according to whether they underwent valve replacement or aorto-coronary bypass surgery. Anesthesia was induced with fentanyl, and cardiopulmonary bypass in all patients was carried out using a bubble-type heart-lung machine. The epinephrine and norepinephrine levels increased during the procedures, but those patients having aorto-coronary bypass surgery showed milder rises than valve replacement patients. IgA, IgG and IgM all dropped as well, but the change in IgG was the greatest, and the decreases were more marked in valve replacement patients than in aorto-coronary bypass patients. It was concluded that, since reactions were different according to the disorder present and were reflected in the variations in catecholamine and immunoglobulin levels, great care is necessary when the patient is removed from the heart-lung machine.

Anesthesia↗

[Diagnosis of adenocarcinoma in transurethral resection of the prostate: how much sampling is adequate].

The amount of prostatic tissue necessary to detect carcinoma in transurethral resection specimens with reasonable accuracy, was evaluated. The samples were taken from the patients with a clinical diagnosis of benign prostatic hypertrophy. Prostate chips from 647 such patients were examined microscopically. An average of 2.5 g of sample was mounted in each block. Adenocarcinoma was diagnosed in 58 cases (9.0%). Among them, 40 cases were in stage A1, and 18 in stage A2. Incidental carcinoma was found more frequently in prostate chips weighing less than 20 g. To detect carcinoma with 95% probability, at least 2 slides should be examined in stage A2, and 6 slides in stage A1.

Adenocarcinoma↗

[A case of adrenal black adenoma associated with Cushing's syndrome].

A 36-year-old female was admitted to Asahi General Hospital because of hypertension. Laboratory findings showed elevated levels of urine 17 (11)-hydroxycorticosteroid and blood cortisol. Computerized tomography and ultrasound sonography demonstrated a round tumor at the suprarenal region. The black tumor, 5 X 3 X 2 cm, was removed by left adrenalectomy. Microscopic findings revealed adrenal adenoma consisting of compact cells containing numerous pigmented granules. Postoperative course was uneventful. Hormonal condition was recovered 11 months after operation.

17-Hydroxycorticosteroids↗

[Incidence of renal diseases in the general population].

The purpose of this study was to determine the incidence of the urological diseases of the kidney. Among 4,094 persons (3,146 men and 948 women) studied, 86 cases of renal cyst, 7 cases of urolithiasis, 3 cases of cystic kidney, and one case of renal cell carcinoma were discovered. The rate of renal cyst was two times higher in men than in women. One sixth of renal cyst patients showed microscopic hematuria. Renal cysts tended to progress in number and size with age. The size of the renal cyst did not correlate with the appearance rate of microscopic hematuria.

Carcinoma, Renal Cell↗

[Clinical evaluation of endoscopic therapy for early gastric cancer by diathermic polypectomy, Nd; YAG laser irradiation and heater probe].

Forty early gastric cancers (37 cases) were treated endoscopically by diathermic polypectomy and Nd; YAG laser irradiation. In 23 cases of protruded early gastric cancer, 16 cases were treated by diathermic polypectomy only, 2 cases by Nd; YAG laser only and 5 cases underwent combination therapy with both procedures. Endoscopic treatment was successful in 20 cases, but surgery was performed in two cases with cancerous invasion or lymph vessel infiltration at their cut ends after polypectomy. Local recurrence occurred in a case of submucosal involvement 6 months after combination therapy. In excavated early gastric cancers, 17 lesions of 14 cases were treated by Nd; YAG laser irradiation. Although 13 lesions disappeared successfully after laser treatment, cancers remained in 3 lesions with submucosal involvement after several irradiations. Local recurrence was experienced in a lesion of poorly differentiated adenocarcinoma three months after treatment. In addition, a heat probe unit for hemostasis was applied for endoscopic treatment of early gastric cancer and found to be effective for cancer of the mucosal layer. Among other early gastric cancers, endoscopic treatment is indicated for differentiated adenocarcinomas which are less than 2 cm in size and confined within the mucosal layer.

Animals↗