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Biomedical subjects

S Sakai

Publications and source records attributed to S Sakai.

At least 379 records · Page 21Linked to original sources

Effect of angiotensin II on the endolymphatic sac direct current potential.

The effect of angiotensin II (ANG II), known as a potent pressor hormone, on the endolymphatic sac direct current potential (ESP) was examined. Intravenous administration of ANG II produced a reversible decrease in the ESP at doses exceeding 0.1 microgram/kg. The effect of ANG II on the ESP was dose-dependent at doses of less than 3 micrograms/kg with a saturated effect at doses of more than 3 micrograms/kg. The maximum reduction of the ESP produced by ANG II was 33.8 +/- 2.9% (m +/- SE, n = 6) of the original amplitude. The action of ANG II on the ESP was blocked by propranolol (beta-adrenergic antagonist). The mechanism underlying the action of ANG II on the ESP is discussed.

Action Potentials↗

Absorption of horseradish peroxidase in the endolymphatic sac: ultrastructural cytochemistry using a new electrophoretic technique.

Using a newly developed injection technique, the absorption of horseradish peroxidase (HRP) in the endolymphatic sac (ES) of the guinea pig was examined by light and electron microscopy. HRP (molecular weight: 40,000; molecular diameter: about 5-nm) was directly injected into the lumen of the ES by electrophoresis after the recording of a direct current potential in the ES lumen. Both the macrophages floating in the ES lumen and the epithelial cells in the intermediate portion of the ES absorbed intraluminal HRP. The macrophages internalized the intraluminal HRP at a higher rate than the epithelial cells, suggesting that macrophages play a major role in macromolecular absorption in the ES. It was considered that the macrophages took up intraluminal HRP by phagocytosis, while the epithelial cells of the intermediate portion took it up by pinocytosis. In contrast, the epithelial cells in the proximal portion of the ES absorbed little HRP. No penetration through the junctional complexes between epithelial cells was observed in either the intermediate or the proximal portion at any interval after the injection of HRP. This finding indicates that these junctional complexes are impermeable to intraluminal HRP.

Absorption↗

[Enophthalmos following radical operation of the maxillary sinus and ethmoidal sinus].

Enophthalmos is usually a consequence of orbital trauma resulting in a blowout fracture of the orbital floor. We report here the case of a 35-year-old male who had a radical operation of the maxillary sinus and the ethmoidal sinus, and 2 months after the operation, developed spontaneous enophthalmos and ocular pain. The left orbit was enophthalmic by 5mm according to Hertel enophthalmometry. Surgical correction was performed under general anesthesia. The left orbit was explored through a transcutaneous incision of the left lower lid which revealed marked periosteal adhesions and absence of the bony floor of the orbit. A rib cartilage graft was used to reconstruct the floor of the orbit, and the globe was brought forward by means of retrobulbar placement. Enophthalmos and ocular pain disappeared postoperatively.

Adult↗

[A case of advanced breast cancer responding to low-dose 5'-DFUR].

A 69-year-old female patient with locally advanced breast cancer with multiple bone metastases (T4cN2-M1) was treated with 5'-DFUR after failure of tamoxifen treatment. The 5'-DFUR dose was limited to 600 mg per day, half the usual dose, because of its gastroenterological side effects. The primary tumor and metastatic axillary lymph nodes regressed three months after the start of treatment, and the complete remission of lesions was obtained in 16 months. Reduction of bone metastasis was confirmed by the disappearance of osteolytic lesion in the skull roentgenogram and the decrease of abnormal accumulation on the bone scintigram. Serum levels of CEA and ST-439 markedly reduced during the treatment as the disease regressed.

Aged↗

[A case of aspirin-induced asthma due to ketoprofen adhesive agent].

A 40-year-old woman who had been diagnosed as having aspirin-induced asthma was admitted with stridor. She had a history of surgery for sinusitis and nasal polyps, and severe asthmatic attack requiring mechanical ventilation after administration of puranoprofen (Niflan). On the second day of hospitalization, she used a ketoprofen adhesive agent (Miltax, 30 mg) for a stiff shoulder. Stridor developed five hours later, progressing to a severe asthmatic attack with loss of consciousness, requiring mechanical ventilation. The serum level of ketoprofen was very high (81.7 ng/ml); therefore, provocation challenge test was performed to confirm the possible relationship between the ketoprofen adhesive agent and asthmatic attack. After closed patching of the agent (15 mg) on her lower leg, stridor developed, and FEV1.0 and PFR decreased, in association with an increase of the serum level of ketoprofen to a maximum of 38.0 ng/ml. These results show that the topical application of a ketoprofen adhesive agent induced the asthmatic attack by transdermal absorption in this patient.

Adult↗

[A case of thymoma with thymic cyst].

A 43-year-old man was pointed out an abnormal shadow on chest X-ray film. Chest CT showed a solid mass and a cyst at anterior superior mediastinum. Operation revealed a capsulated thymoma and a multilocular thymic cyst. PTH and CA19-9 level in the cystic fluid was elevated. Histological examination demonstrated the clear separation of the mixed type thymoma and the thymic cyst. There were few reports for cases of thymoma with a thymic cyst.

Adult↗

[Cardiac herniation after right pneumonectomy].

Cardiac herniation is a rare, but highly lethal complication of intrapericardial pneumonectomy for progressive carcinoma of lung, and occurs in early postoperative period. Our patient with this complication presented sudden onset of severe hypotension and cyanosis after several ventricular premature beats. We suspected cardiac herniation as we observed dilatation of cervical veins and rightward deviation of heart sound. The patient was immediately positioned on his left side and systemic blood pressure increased soon. After verification of the incident by chest X-ray film, emergency operation was performed. Fortunately, vital signs were stable during and after reoperation and the patient could survive.

Heart Diseases↗

[Prophylactic use of antibiotics for fever following fiberoptic bronchoscopy and bronchography].

To evaluate the effect of bacampicillin hydrochloride on fever following fiberoptic bronchoscopy and bronchography, we conducted multi-institutional randomized study. In bronchographic examinations, the rise of body temperatures in the bacampicillin group (0.82 +/- 0.13 degrees C: mean +/- SE) was significantly smaller than that in the control group (1.39 +/- 0.25 degrees C) on the second day of examination. Bacterial infection may contribute to the rise of temperature on the day following bronchography, but no pneumonia or sepsis was observed. There was no differences in the rise of body temperature on the first, third or fourth day. In fiberoptic bronchoscopic examinations, there was no difference between the two groups. We conclude that there is no clinical indication of the value of prophylactic use of antibiotics in either fiberoptic bronchoscopy or bronchography.

Adult↗

[A case of Hodgkin's disease with endotracheal tumor presenting with severe airflow obstruction].

A 22-year-old woman was admitted to our hospital complaining of productive cough and dyspnea even at rest, and marked cervical lymphadenopathy. Marked stridor and orthopnea were observed, and auscultation of the chest revealed widespread expiratory wheeze which was not relieved by bronchodilators administered intravenously. Chest X-ray and CT scan revealed hilar lymphadenopathy and invasive tumor of the mediastinum. Bronchoscopy demonstrated narrowing of the trachea anteriorly and posteriorly and a submucosal nodular tumor protruding from the right anterior wall, causing approximately 90% occlusion of the lumen of the lower third of the trachea, but distal bronchi were intact. Microscopic findings of inguinal lymph node biopsy specimen revealed mixed cellular lymphoma compatible with Hodgkin's disease. Systemic chemotherapy resulted in relief of symptoms, and two months later, the endotracheal tumor had disappeared bronchoscopically, with slight residual stenosis of the trachea. Before treatment, pulmonary function tests indicated markedly impaired forced volume in 1 second in both expiratory and inspiratory cycles, especially in the latter phase. After remission, however, obstructive ventilatory dysfunction was observed. The cause of prolonged air flow obstruction was thought to be marked infiltration and almost total involvement of the tracheal wall by tumor with a nodular appearance of the lumen. Endotracheal tumor in Hodgkin's disease is rare, and there are few reports on pulmonary function associated with intrathoracic involvement of malignant lymphoma.

Adult↗

Effect of hyperlipidemic serum on cultured mesangial cells.

Hyperlipidemia may contribute to the progression of focal glomerular sclerosis (FGS) in humans and obese Zucker rats. Zucker rats undergo an increase in their plasma low density lipoprotein (LDL), very low density lipoprotein (VLDL) and oxidized lipids, resulting in the development of FGS. We examined the effects of such hyperlipidemic serum on thymidine uptake into cultured mesangial cells. LDL and VLDL both stimulated the overnight uptake of 3H-thymidine at a concentration of below 10 micrograms/ml and inhibited this uptake at over 50 micrograms/ml in the medium. Modified LDL and VLDL after oxidation, however, inhibited this uptake at a concentration of 1 microgram/ml in the medium. Although 20% serum-containing medium stimulated the thymidine uptake by the mesangial cells, the lipoprotein fraction inhibited the uptake, while the lipoprotein-free fraction markedly stimulated it. We conclude therefore that the lipoproteins in hyperlipidemic serum suppress and the lipoprotein-free fraction stimulates mesangial growth. Both may play a role in the development of FGS in rats.

Animals↗

[A case of invasive thymoma responsive to preoperative chemotherapy].

A 38-year-old male was admitted with edema of the neck and face. Chest X-ray revealed a mediastinal tumor. On chest CT and MRI, a tumor infiltrating the superior vena cava and bilateral brachiocephalic veins in the upper mediastinum was observed. Venography revealed obstruction of bilateral brachiocephalic veins. The tumor was diagnosed as thymoma by percutaneous biopsy, but since it was of stage III according to Masaoka's classification, complete extirpation was considered to be impossible. Preoperative chemotherapy with multiple drugs (CDDP, ADM, VCR, CPA) was administered. The superior vena cava syndrome resolved and the tumor diminished in size. Because of leukopenia, rhG-CSF was also used. The tumor infiltrated the left brachiocephalic vein; therefore, total resection and left brachiocephalic vein reconstruction were performed. Histopathological examination showed extensive, necrosis and fibrosis containing residual thymoma. Postoperatively, similar chemotherapy and cobalt irradiation (40 Gy) to the superior mediastinum were performed. We thus present a case of invasive thymoma which responded to preoperative chemotherapy.

Adult↗

[A case of invasive thymoma which had grown in the SVC via left innominate vein through thymic vein].

A 66-year-old male was referred to our department with mediastinal tumor. The chest X-ray and the chest CT showed a large tumor adjacent to pulmonary artery and descending aorta. Cavogram revealed a filling defect of the SVC. He underwent complete resection of the tumor, resection of the SVC and reconstruction of the SVC with ringed PTFE. The main tumor was 12 x 7 cm in size and the tumor in the SVC was 20 x 15 mm in size. Histopathological findings showed a lymphocytic thymoma. Compact invaded nest of tumor cell was found in the innominate vein. The tumor in the SVC was invasive to the intima of the SVC, but its media and adventure were intact. This case is rare among patients with invasive thymoma as far as the growth is concerned.

Aged↗

[Intra-arterial chemotherapy of local recurrence and non-curative case of colorectal cancer].

Twelve colorectal cancer patients, including 9 with local recurrent cancer and 3 with remnant cancer after surgery, were treated with intraarterial chemotherapy. Three cases were treated with MMC injection alone, 1 case with MMC combined with irradiation (MMC-R) and 8 cases with ADM combined with irradiation (ADM-R). In 7 evaluable patients, the response rate was 28.6% with 1 CR case, 1 PR case and 5 NC cases. The 2 cases treated with ADM-R were successful. Six of 8 patients treated with ADM-R survived more than 1 year, while all 4 patients treated with MMC or MMC-R died within 8 months. The cumulative survival rate after ADM-R treatment was 44% at 24 months. It is suggested that the combination of intra-arterial chemotherapy and radiation therapy is an effective treatment for local recurrence and non-curative cases of colorectal cancer.

Chemotherapy, Adjuvant↗

[The effects of position and ventilation during thoracotomy on oxygen uptake and carbon dioxide elimination in humans].

The effects of position and ventilation were investigated in ten adult patients undergoing scheduled thoracotomy. Oxygen uptake (VO2) and carbon dioxide elimination (VCO2) in gas phase were measured continuously, while gas exchange ratio (R) and dead space ventilation ratio (VD/VT) were calculated with these results. VO2 and VCO2 during general anesthesia decreased about 60% from the normal values due to reduction of metabolism. Position and ventilation had no obvious effect on VO2 during surgery. VCO2 decreased slightly during bilateral ventilation with lateral decubitus position, because of mismatch of ventilation-perfusion distributions, and/or reduction of metabolism without surgical stress. The results suggest that carbohydrate calories are mainly metabolized under surgical stress, resulting in an R equal to 1.0. Continuous non-invasive monitoring of VO2 and VCO2 is one of the most effective parameters to evaluate the oxygen balance and systemic metabolism.

Adult↗

[A case of invasive thymoma with retroperitoneal recurrence].

A case of invasive thymoma with retroperitoneal recurrence is reported. A 55-year-old man with invasive thymoma (Masaokas classification, Stage IVa) underwent thymo-thymectomy, partial resection of left upper lobe, resection of phrenic nerve and partial resection of parietal pleura on March 14, 1989. Histological findings revealed thymoma with predominantly lymphocytic type. Two years after the operation, the tumor of retroperitoneal recurrence was discovered in abdominal CT. This retroperitoneal tumor was huge in size (16 x 12 cm) and extended into posterior mediastinum via aortic hiatus. The patient underwent resection of tumor through thoracotomy and laparotomy on April 23, 1991, after two cycles of chemotherapy. Histological findings revealed thymoma with predominantly lymphocytic type. This case was rare among patients with recurrence of thymoma as far as the site of recurrence is concerned.

Humans↗

[The candida antigen titer by CAND-TEC in patients with pulmonary disease].

In order to elucidate the background of candida infection in patients with pulmonary disease, we divided 100 patients into 2 groups according to their serum titer of CAND-TEC determined by latex agglutination test for candida antigen. Group C1 (83 patients) had CAND-TEC value less than 2:1, and Group C2 (17 patients) had CAND-TEC value greater than 4:1. There was a significantly higher incidence of respiratory failure, hypoalbuminemia, and fever unresponsive to antibiotics in Group C2 compared with Group C1. Regarding the sputum culture of candida, there were significantly more positive cases in Group C2 than in Group C1. Furthermore, Group C2 showed a significantly poorer prognosis than Group C1. Generally, the candida antigen titer correlated well with clinical findings and with the course of infection and treatment with antifungal drugs. These results suggest that administration of antifungal drugs may be indicated in patients with fever unresponsive to antibiotics when the candida antigen titer is greater than 4:1.

Antigens, Fungal↗

[Preservation of the heart with University of Wisconsin solution--hemodynamic and morphological evaluation in a canine heterotopically transplanted heart].

University of Wisconsin (UW) solution has been reported to extend the safe cold ischemic time in the preservation of the liver, kidney and pancreas. However, there have been few reports of safe cold ischemic time in heart preservation with UW solution. The purpose of this study was to find whether UW solution can extend the safe cold ischemic time in cardiac transplantation in dogs. Heterotopic cardiac transplantation was performed in mongrel dogs after cold ischemic preservation of the hearts with UW solution, ischemic time 8, 16 and 24 hours (Gr.UW8, Gr.UW16 and Gr.UW24, respectively) and with GIK solution, ischemic time 4 hours (Gr.G4) which is considered the safe cold ischemic time in clinical cardiac transplantation. The following was studied: 1) Emax of the LV, myocardial contraction, by pressure-volume curve with the volume measured conductance catheter method, 2) myocardial tissue blood flow of the LV (MTBF), with laser doppler tissue flow meter, 3) serum CPK and electron microscopical evaluation. Emax and MTBF were measured before transplantation and after reperfusion. Their results were expressed as percentage of the values before transplantation. As results, after 120 minutes from reperfusion, Emax was recovered to 94 +/- 13% in Gr.G4, 104 +/- 11% in Gr.UW8, 67 +/- 22% in Gr.UW16 and 66 +/- 16% in Gr.UW24. Emax in Gr.G4 and Gr.UW8 were significantly (p less than 0.01) higher than that in Gr.UW16 and Gr.UW24. After 120 minutes from reperfusion, MTBF was recovered to 90 +/- 19% in Gr.G4, 98 +/- 9% in Gr.UW8, 63 +/- 19% in Gr.UW16 and 61 +/- 6% in Gr.UW24.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenosine↗