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Biomedical subjects

S Osaka

Publications and source records attributed to S Osaka.

At least 37 records · Page 2Linked to original sources
PubMed1993

Nasu-Hakola disease. A case accompanied by abnormalities in fatty acid composition of serum total lipids and amino acid analysis.

A case of Nasu-Hakola disease (membranous lipodystrophy) was reported. The patient is a 33-year-old man who started to have pathological fractures at the age of 24 years. Then, neurological symptoms such as dementia appeared gradually. A biopsy specimen of the bone showed membranocystic changes of the adipose tissue. T2-weighted magnetic resonance images of the head showed low intensity in bilateral putamens, internal capsules, globi pallidi and caudate nuclei. One of his brothers has the same disease. In both patients, fatty acid composition of serum total lipids showed increased nervonic acid and plasma amino acid analysis showed decreased glutamine.

Adult↗
PubMed1992

[Effects of enflurane, isoflurane, and sevoflurane on renal tubular functions].

Twenty-seven patients without renal disease were divided randomly into three groups of each nine patients. Each group received either enflurane, isoflurane or sevoflurane. The renal tubular functions were examined during anesthesia and on the first postoperative day. By inhalation of 1.49 MAC hours of enflurane, 2.17 MAC hours of isoflurane or 1.29 MAC hours of sevoflurane, creatinine clearance, Na excretion rate, urine beta 2-microglobulin and urine N-acetyl-beta-D-glucosaminidase showed no significant changes during anesthesia and the during postoperative period among anesthetic agents used. These results indicate that enflurane, isoflurane or sevoflurane does not affect renal tubular function specifically under anesthesia when each was given for less than four hours.

Adult↗
PubMed1991

Targeting of liposomes surface-modified with glycyrrhizin to the liver. I. Preparation and biological disposition.

We consider glycyrrhizin to be a new ligand for liposomes to the liver because it is known that about 80% of glycyrrhizin is excreted into the bile after intravenous administration in rats. In order to modify the liposomal surface with glycyrrhizin, 30-stearyl glycyrrhizin (GLOSt), one of the lipophilic glycyrrhizin derivatives, was synthesized. The structure of this new compound was identified by nuclear magnetic resonance (NMR), infrared (IR) and mass spectra (MS). Sonicated liposomes were prepared from hydrogenated egg phosphatidylcholine-cholesterol-GLOSt or dicetyl phosphate (DCP) (4:4:1) and were labelled with [3H]inulin as an aqueous marker. It was confirmed by measuring the encapsulation efficiencies and the mean diameters that GLOSt-containing sonicated liposomes (GLOSt-SUV) were SUV-type as well as DCP-containing control liposomes (control-SUV). Four hours after intravenous injection into rats at a dose of 90 mumol as total lipid per kg of rat body weight, GLOSt-SUV showed 4-fold more accumulation (42.4%) in the liver than control-SUV. Therefore, glycyrrhizin is considered to be a useful new ligand on liposomes for targeting to the liver.

Animals↗
PubMed1991

[Treatment and prognosis of giant cell tumor in the sacrum--study of Bone Tumor Registry in Japan].

The prognosis of giant cell tumors arising in the sacrum is difficult to ascertain. Because of the low incidence in Japan there are scanty statistics. We selected 14 cases from the Bone Tumor Registry in Japan. Questionnaires were sent to hospitals which had submitted cases, regarding Enneking's staging, surgical approach, surgical procedure, radiotherapy, chemotherapy, complications and prognosis of this tumor. The results of the questionnaire show that surgery alone gives better results than combined surgery and radiotherapy. Good prognosis called for surgery alone. Curettage resulted in no evidence of disease (NED) in four cases. Bad prognosis called for combined surgery, radiotherapy and chemotherapy. If we surmise from the biological behavior of the giant cell tumor, that the tumor mass extends out extraosseously en-bloc excision with nerve roots is indicated. Extensive curettage will be adequate if the tumor is confined intraosseously. Radiotherapy should not be selected except for inoperative cases.

Adolescent↗
PubMed1990

[A case report of coronary artery bypass grafting with the left internal mammary, the right gastroepiploic, and the inferior epigastric arteries].

We performed coronary artery bypass grafting with the left internal mammary artery, right gastroepiploic artery, and inferior epigastric artery on a 60-year-old male. The inferior epigastric artery used as a free graft was placed between the in situ left internal mammary graft proximally and the obtuse marginal branch distally. Both the left internal mammary graft to the left anterior descending artery and the right gastroepiploic artery to the right coronary artery were used as an in situ graft. All grafts were patent two weeks after the operation and the patient was free from angina at three months follow-up period.

Abdominal Muscles↗
PubMed1990

[Successful re-reconstruction for complete disruption of the right main bronchus by blunt chest trauma].

A 22 year-old man was brought to our hospital about twenty-three minutes following a high-speed motorbicycle accident in which he had blunt chest trauma. He was in severe respiratory distress with marked dyspnea and restless with extensive subcutaneous emphysema involving anterior chest wall, cervical and bilateral inguinal regions. A chest X-ray revealed bilateral pneumothorax involving mediastinal emphysema and also fracture of right submandibular and clavicula. In spite of orotracheal intubation and insertion of bilateral chest tube, continuous air leak and pneumothorax did not improve. Bronchoscopy revealed the disruption of mucosa of the right main bronchus at the bifurcation. Emergency right thoracotomy was performed and there was the complete disruption of the right main bronchus. Anastomosis of the right main bronchus with circumferential resection was undertaken on May 30, 1987 about two hours after trauma. About three months after reconstruction, bronchoscopic examination revealed stomal stenosis with deformation of tracheobronchial cartilage and granulation. The stenosis showed severe irregularity by deformed cartilage and thickened scar, so widening by Nd-YAG laser vaporization was inadequate in effect. Seven months after first reconstruction, we performed re-reconstructive operation, right upper sleeve lobectomy with partial resection of carcina and right wall of trachea for scar with severe deformation of cartilage. Following the operation, the patient suffered from sepsis with pneumonitis accompanied by lung edema. This complication was treated successfully. We considered that acute pneumonitis was caused by reventilation with increase of perfusion after tracheobronchial reconstruction. Consequently, we thought it important to treat such patients with long term IPPB postoperatively with adequate medication for respiratory system.

Accidents, Traffic↗
PubMed1990

[Surgical treatment of postinfarction left ventricular free wall rupture--experience of 12 cases including 2 successful repairs of acute (blow out) rupture].

Left ventricular free wall rupture (LVFWR) complicating myocardial infarction is still a lethal complication. Although there have been reports of successful repair of LVFWR, most of them were of subacute type in which main symptom was cardiac tamponade and the surgical repair was undertaken several hours after the onset of rupture. Between March, 1984 and June, 1987. We treated 12 cases of LVFWR surgically, thoracotomy and open drainage in 2 cases, thoracotomy and direct closure of rupture in 8 cases, median sternotomy and patch closure of rupture in 2 cases. We used cardiopulmonary bypass (CPB) only in 3 cases, because most of the cases except two developed electromechanical dissociation abruptly, requiring an emergency thoracotomy and there was no time for establishing CPB. In the cases of electromechanical dissociation, cardiopulmonary resuscitation and an emergency thoracotomy were performed simultaneously. There were three early survivors (greater than 30 days) by emergency thoracotomy and direct closure of rupture and one survivor (double rupture case) by patch closure on CPB. We believe that acute type of LVFWR in which initial symptom is electromechanical dissociation without any preceding symptoms can be rescued by emergency thoracotomy and direct closure of rupture with no aid of CPB if rupture is a small tear of anterior or lateral left ventricle. For this purpose, prompt diagnosis is mandatory and this is possible by two dimensional echocardiogram even during cardiopulmonary resuscitation.

Acute Disease↗
PubMed1989

[Sternotomy wound closure with polyester tapes].

We developed the special polyester tape with Tetron coating for sternal closure. Fifty consecutive open heart cases had the sternum closed with the tapes in the past six months at Nippon Medical School Hospital. There was no sternal infection or mediastinitis postoperatively. The tape closure method was more effective in approximation of sternum than the ordinary wire closure, especially in the case with fragile sternum. Although a long term follow-up is necessary, the result of sternal closure with the polyester tape has been satisfactory.

Humans↗
PubMed1989

[Historical improvement in the treatment of osteosarcoma].

In the past decade, advances in chemotherapeutic agents and in diagnostic devices have led to improvement in the results of treatment for osteosarcoma. To evaluate the factor which brought about such improvement, historical therapeutic regimens were analysed. Eighty-three osteosarcoma cases were treated in our institute from 1955 to 1988 and categorized into six groups with the following therapeutic regimens: N-0: No treatment (including biopsy) N-1: Surgery alone N-2: Post surgery adjuvant therapy N-3: Intra-arterial continuous infusion N-4: Distal arterial blockade infusion N-5: Balloon-occluded arterial infusion. (N-3, 4 and 5 imply neo-adjuvant chemotherapy). Overall five-year survival rate was 48.8% (included Enneking's stage III). The survival rate improved from N-1 to N-5 in stepwise fashion, and N-5 reached 80% at two-year survival. We concluded that neo-adjuvant chemotherapy was not only effective to control the local lesion but also to prevent lung metastasis.

Antineoplastic Agents↗
PubMed1989

[Treatment and prognosis of sacrococcygeal chordoma--study of bone tumor registry in Japan].

Prognosis of chordoma arising in the sacrococcygeal area is difficult to assess because of the small number cases and lack of statistics in Japan. From the bone tumor registry we selected records on sacrococcygeal chordoma cases and sent a questionnaire to many hospitals regarding staging, surgical approach, surgical procedure, radiotherapy, chemotherapy, complications and prognosis of this tumor. The results of the questionnaire (32 cases) showed that combined surgery and radiotherapy were the best methods. This survival rate was 85% in five years and 43% in ten years. In the surgical procedure the extralesional excision resulted in a high recurrence rate (73%) three years after operation, and in the case of intralesional excision an even higher rate (91%). We assume this is a problem of the excisional method. In the staging system, the intracompartment tumors have a better prognosis. Early stage discovery and surgical treatment is of vital importance.

Adult↗
PubMed1988

Early and late results of re-operation for coronary artery disease: a 13-year experience.

A second coronary artery bypass grafting procedure was performed for recurrent angina in 119 patients between 1970 and mid-1983. Angiographic findings were assessed and computerized using the Brandt myocardial scoring system. The myocardial score was similar prior to the first and second operations. Graft failure was the most common indication for re-operation, either alone (48%) or in combination with progression of coronary artery disease (29%) or incomplete revascularization (10%). Progression of coronary artery disease alone was an indication in 9% and previous incomplete revascularization alone in 4%. The completeness of revascularization at the end of operation was analysed using a new index, the myocardial score/graft coverage rate. This showed that revascularization was less complete at the second operation than at the first (P less than 0.0001). The hospital mortality at re-operation was 2.5% and the peri-operative myocardial infarction rate was 9.2%. The follow-up period was 54 months (range 10-160 months). Actuarial survival was 94% at 5 years and 74% at 10 years. The average onset of recurrent angina was earlier after the second operation than after the first (P = 0.001). Using a cumulative actuarial curve, survival at 8 years was 85%, a further 6% of patients had undergone a third or fourth operation, and a further 25% were in NYHA Classes III or IV. Therefore 54% achieved a good or excellent result. It was concluded that re-operation is a worthwhile procedure.

Angina Pectoris↗
PubMed1988

[Surgical treatment of bone and soft tissue tumors in the sacroiliac area--low- and high-grade neoplasms].

Operative treatment of tumors in the sacroiliac area is very difficult for the orthopedic surgeon. We reviewed low- and high-grade neoplasms in the sacrum and part of the ilium. Primary bone tumors were giant cell tumor, chondrosarcoma and others; invading bone tumors were carcinoma, rhabdomyosarcoma and others; soft tissue tumors were liposarcoma, metastasis of extraskeletal chondrosarcoma and others; total, 19 cases. The preoperative treatment performed was embolization, intra-arterial infusion (chemotherapy) and radiation therapy. The surgical approach used were the posterior, posterolateral, anterior and posterior, anterior and lateral combined approach. The transiliac procedure using the posterolateral approach gives better visualization adjacent to the sacroiliac area. The gap between the sacrum and the ilium is bridged by grafting the resected ilium. The anterior and lateral combined approach was used in the resection of large iliac tumors, and the abdominoinguinal approach was selected for large retroperitoneal tumors. The surgical treatment performed ranged from simple to wide excision, including the external iliac vessels or rectum, and also palliative surgery. Reconstructive surgery was done for reconstruction of the pelvic ring, spinal fusion using instrumentation and replacement of artificial vessels. Many complications and functional loss requiring treatment were encountered.

Adolescent↗
PubMed1987

Surgical treatment of giant cell tumors of the pelvis.

There are many problems concerning management of giant cell tumors in the pelvis: diagnosis, surgical approach, adequacy of treatment, reconstruction, and prognosis. Of 58 cases of giant cell tumor of bone from 1962 to 1985, five cases arose in the pelvis, two in the ilium, two in the ischium, and one in the pubis. Surgical procedures included en bloc excision in four cases and intralesional excision in one. Reconstruction included sacroiliac fusion in one, iliofemoral fusion in one, and pelvic prosthetic replacement in another. Recurrence and metastasis did not occur in any of the cases. All patients were able to walk without crutches. A good surgical approach isolates major vessels and nerves, and permits excision to prevent recurrence and control bleeding. Reconstructive surgery may be required for treatment of a pelvic giant cell tumor.

Adult↗
PubMed1984

Effects of intraaortic balloon pumping on acute myocardial infarction in 64 cases of cardiogenic shock, severe heart failure and mechanical heart failure.

Of the patients treated in the CCU of Nippon Medical School for acute myocardial infarction in the past 5 years and 8 months, 44 with cardiogenic shock, 11 with severe heart failure, 7 with ventricular septal perforation and 2 with mitral regurgitation were treated by IABP. The peak effect of IABP on the hemodynamics of patients with cardiogenic shock was noted 24 hours after starting on IABP. When hemodynamics were compared between surviving and dead groups, there was a significant difference in stroke volume index between the two groups. When left ventricular function was compared between them, it was suggested that patients whose left ventricular function does not respond to IABP for 48 hours or longer are more likely to die than responders. Twenty-four of 44 patients became independent of IABP, but no more than 13 patients (30%) survived for 6 months or longer. Isosorbide dinitrate (ISDN) was combined with IABP in 7 patients who had a persistence of heart failure in spite of IABP. Combination therapy with IABP and ISDN elicited a significant increase in cardiac index, a significant decrease in pulmonary capillary wedge pressure, mean pulmonary arterial pressure and total peripheral resistance and a pronounced improvement in left ventricular function, and all 7 patients became independent of IABP. In the patients with acute myocardial infarction complicated with ventricular septal perforation, the mean systolic arterial pressure was 87.7 +/- 8.3 mmHg, mean pulmonary capillary wedge pressure, 20.3 +/- 7.4 mmHg and pulmonary-to-systemic flow ratio, 3.12 +/- 0.95 before starting on IABP. When the hemodynamics at 3 hours of IABP were compared to the pre-IABP values, the right atrial pressure, pulmonary capillary wedge pressure and pulmonary-to-systemic flow ratio had a tendency to decline, but the changes were not statistically significant, except for the peak arterial pressure which showed a significant elevation at 3 hours of IABP. Three of the 7 patients became dependent on IABP, and 2 of the 3 patients were saved by emergency operation.

Aged↗
PubMed1984

Clinical usefulness of intraaortic balloon pumping in acute myocardial infarction complicated with cardiogenic shock, ventricular septal perforation and mitral regurgitation.

UNLABELLED: The effects of intraaortic balloon pumping (IABP) were studied in 91 patients with acute myocardial infarction complicated with cardiogenic shock (75 pts), ventricular septal perforation (VSP) (12 pts), and/or mitral regurgitation (MR) (4 pts). Out of 44 pts with cardiogenic shock in whom IABP was performed, 14 pts could not recover from cardiogenic shock, 6 pts became dependent on IABP and 13 pts survived (29.5%). In contrast, out of the remaining 31 pts with cardiogenic shock who did not undergo IABP because of inability to insert IABP catheter or other reasons and were treated medically, only 3 pts survived (9.7%, p less than 0.05). After the initiation of IABP, BPd, CI, SVI, SWI, TMG increased significantly, and HR, CVP, PCWP, TPR decreased significantly. Comparison of hemodynamic parameters after the initiation of IABP showed that SVI and SWI at 24 hours were higher and CVP lower in survivors. Out of 7 pts with VSP who underwent IABP 2 pts were operated and survived. IN CONCLUSION: short-term mortality in pts with cardiogenic shock was significantly lower in IABP-treated group, hemodynamic parameters improved after IABP, survivors from cardiogenic shock had higher SVI, SWI, BPd, and lower CVP than non-survivors, patients with VSP and MR had worse prognosis in spite of IABP.

Adult↗