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Biomedical subjects

S Torii

Publications and source records attributed to S Torii.

At least 55 records · Page 3Linked to original sources
PubMed1998

A new postoperative management scheme for preventing sacral pressure sores in patients with spinal cord injuries.

Although the reliability of pressure sore surgery has improved with the advent of many different types of flaps, it is well known that the recurrence rate of pressure sores is still remarkably high in spinal cord-injured patients. This article reports the very low relapse rate of postsurgical pressure sores using air mattresses, which also helps relieve manpower requirements for care. We measured interface pressures at the sacrum for 18 spinal cord-injured patients with a ROHO air mattress (ROHO International, Inc, Belleville, IL). Based on the results, we used this mattress immediately after surgery for 19 spinal cord-injured patients with sacral pressure sores. Minimal repositioning was performed for each patient during the hospital stay. Minimal repositioning was similarly performed at home. All pressure sores healed, regardless of the type of surgical procedure, size, and degree of sore. No relapse has been found, with an average of 33.4 months after surgery. With this management, we could achieve a very low recurrence rate, require less manpower for postoperative management, as well as minimize stress for the patients.

Adult↗
PubMed1998

Effect of omental lipid fraction on enhancement of skin flap survival.

The effect of an omental lipid fraction on the rate of skin flap survival in the back of the rat was assessed by planimetric and histological examination. Compared with the control group, those rats treated with the omental lipid fraction showed significant improvement of the flap survival area. On histological examination, the flap instilled with the omental lipid fraction showed vasodilatation and neovascularization between the flap and the bed. A topical application of the omental lipid fraction enhanced the skin flap survival area, and showed vasodilatation in the flap and neovascularization between the skin flap and the recipient bed.

Animals↗
PubMed1998

Results of omental flap transposition for deep sternal wound infection after cardiovascular surgery.

OBJECTIVE: Our experience with omental flap transposition in the treatment of deep sternal wound infections is reviewed here with an emphasis on efficacy, risk factors for in-hospital mortality rates, and long-term results. SUMMARY BACKGROUND DATA: Even with improvements in muscle and omental flap transposition, the timing of closure and the surgical strategy are controversial. METHODS: Forty-four consecutive patients with deep sternal wound infections were treated using the omental flap transposition from 1985 through 1994. The strategies included debridement with delayed omental flap transposition or single-stage management, which consisted of debridement of the sternal wound and omental flap transposition. Methicillin-resistant Staphylococcus aureus was cultured from more than 50% of the wounds. A logistic regression analysis was used to identify the predictors of in-hospital death after omental flap transposition. RESULTS: There were seven (16%) in-hospital deaths. Univariate analysis demonstrated that hemodialysis and ventilatory support at the time of omental flap transposition were significantly associated with in-hospital mortality rates (p = 0.0023 and p = 0.0075, respectively). Thirty-seven patients whose wounds healed well were discharged from the hospital. Two patients with cultures positive for methicillin-resistant Staphylococcus aureus had recurrent sternal infections. Patients without positive methicillin-resistant Staphylococcus aureus cultures had good long-term results after reconstructive surgery. CONCLUSIONS: Transposition of an omental flap is a reliable option in the treatment of deep sternal wound infections, unless the patients require ventilatory support or hemodialysis at the time of transposition.

Adult↗
PubMed1998

Endoscopic omental harvest.

An omental flap is useful in reconstructive surgery, but harvesting such a flap generally requires laparotomy. However, endoscopic surgery facilitates harvesting an omental flap without open laparotomy. We performed endoscopic omental harvest in two patients. We described the procedure of endoscopic omental harvest, which is different from that reported previously. Four access ports were required: two placed lateral to the right rectus margin, one placed lateral to the left rectus margin, and one placed in the infraumbilical area. The stomach was suspended from the peritoneum for the dissection of the gastric rami. The vessels from the gastroepiploic arcade to the greater curvature of the stomach were individually clipped and divided. The omentum then was dissected to the transverse colon and the lower portion of the omentum was dissected along the transverse colon. Finally, the right side of the omentum was dissected. The omentum was transferred using the right gastroepiploic vessels for anastomosis. The advantages of endoscopic harvest are an inconspicuous scar, minimal operative pain, and early recovery. The disadvantages include a long procedure time. At the present time, endoscopic harvest of the left side of the omentum is problematic because of difficulty in identifying the left omental artery and the risk of injury to the spleen. However, these limitations will likely be resolved in the future.

Endoscopy↗
PubMed1998

[Intravenous immunoglobulin (GB-0998) for prophylaxis of recurrent acute otitis media and lower respiratory tract infection in infancy with IgG 2 deficiency].

The prophylactic effect of intravenous immunoglobulin (GB-0998) on the recurrent acute otitis media, bronchitis and bronchopneumonia in IgG 2 deficient infants was investigated in a multicenter trial. GB-0998 was administered 6 times every 4 weeks. The doses were 300 mg/kg wt. during the first treatment, followed by 5 doses of 200 mg/kg wt. The results indicated that GB-0998 was effective in the prophylaxis of the recurrent infection of acute otitis media, bronchitis and bronchopneumonia in infancy with IgG 2 deficiency and/or IgG 2 antibody deficiency specific for Streptococcus pneumoniae.

Acute Disease↗
PubMed1998

The interaction between vitamin A and thiazolidinedione on bovine adipocyte differentiation in primary culture.

We studied the effects of a thiazolidinedione (T-174) and retinoids on adipocyte differentiation in beef cattle. Stromal-vascular (SV) cells containing preadipocytes were prepared from perirenal adipose tissue of 21-mo-old Japanese Black steers. After confluence, these cells were cultured in 25 microM T-174, which is a specific ligand for an adipogenesis stimulating nuclear receptor (i.e., gamma subtype of peroxisome proliferator-activated receptor [PPARgamma]), with 1 microM all-trans retinoic acid (RA) or .4 to 40 microg/100 mL of retinol for 10 to 14 d. The number of cells accumulating lipid droplets was counted as morphologically differentiated adipocytes, and the activity of glycerol-3-phosphate dehydrogenase (GPDH), a biochemical index for the differentiation, was determined. The number of lipid-laden cells and GPDH activity were increased by the addition of T-174. All-trans retinoic acid completely blocked the stimulative action of T-174. The addition of retinol also decreased the number of lipid-laden cells and GPDH activity in a dose-dependent manner. These results showed that the thiazolidinedione stimulated adipocyte differentiation and the retinoids blocked the adipogenesis induced by the thiazolidinedione in primary culture of bovine SV cells. Peroxisome proliferator-activated receptor gamma may play an important role in adipocyte differentiation, and retinoids may interfere with the action of PPARgamma in cattle.

Adipocytes↗
PubMed1998

Origin of enamel prisms and Hunter-Schreger bands in reptilian enamel.

Enamel prisms in mammalian enamel structure including human are considered to have originated in the reptilian enamel. The author has reported the original pattern of enamel prisms and of Hunter-Schreger bands in fossil reptiles of Mosasaurus sp. and Phytosaurus sp. The origin of the patterns of crystallite groups appear to arise in the fossil reptiles. Mosasaurus sp. had an island pattern and Phytosaurus sp. had a slender pattern. These two types are of various sizes, and are formed by variable numbers of ameloblasts. The number of ameloblasts involved in the formation of the crystallite group may change during amelogenesis. The present study observed the initial crystallite groups as enamel islands, in the surface of the early secretory stage of amelogenesis of living Alligator mississippiensis. These crystallite groups become bigger and more uniform in size during amelogenesis, being formed by several ameloblasts in the maturation stage. The border of crystallite groups observed appear as the lamella in human enamel. These crystallite groups may develop into the enamel prisms and Hunter-Schreger bands.

Animals↗
PubMed1998

[Respiratory symptoms by oral challenge tests with egg white antigens in egg-allergic children].

One hundred and ninety one subjects showing histories of immediate hypersensitive response to egg white ingestion and/or positive IgE antibody titers specific for egg white were enrolled in double-blind placebo-controlled oral challenge with freeze and dried, heated or heated and ovomucoid-depleted egg white antigens. Seventy seven were male and 114 female, and their ages ranged from 11 month to 10 years 5 month; 118 of them had atopic dermatitis, seven had asthma and 33 had both atopic dermatitis and bronchial asthma and 33 had urticaria. One hundred four children developed 147 positive symptoms including 131 immediate reactions and 16 non-immediate reactions by oral challenge tests. Respiratory symptoms were observed in 25 cases (17%) including cough alone in 12 cases (8.2%), and both wheezing and cough in 13 cases (8.8%). These were all observed as immediate reactions and accompanied with dermal symptoms. Frequency of respiratory symptoms correlated with specific IgE antibody titers for egg white. Heated and ovomucoid-depleted egg white was more hypoallergenic that heated or freeze and dried egg white with respect to respiratory symptoms as well as other symptoms. We concluded that respiratory symptoms were provoked through oral challenges with egg white in a part of egg-allergic children.

Administration, Oral↗
PubMed1997

Midkine, a retinoic acid-inducible heparin-binding cytokine, is a novel regulator of intracellular calcium in human neutrophils.

Midkine (MK), which induces chemotaxis of human neutrophils, was found to trigger mobilization of intracellular calcium of these cells. The maximum response was observed 150 sec after exposure to MK, suggesting a complex mechanism in the process. The calcium mobilization was inhibited by herbimycin A, Bordetella pertussis toxin and wortmannin, suggesting that a tyrosine kinase, a G protein-linked receptor and phosphatidyl inositol 3 kinase are involved in the process.

Androstadienes↗
PubMed1997

Apoxin I, a novel apoptosis-inducing factor with L-amino acid oxidase activity purified from Western diamondback rattlesnake venom.

Venom of the western diamondback rattlesnake (Crotalus atrox) induces apoptosis in human umbilical vein endothelial cells, which could result in hemorrhage in tissues bitten by the snake. To identify the hemorrhagic factor, we purified a novel protein, apoxin I, from rattlesnake venom. Apoxin I induced apoptosis in human umbilical vein endothelial, human promyelocytic leukemia HL-60, human ovarian carcinoma A2780, and mouse endothelial KN-3 cells. Amino acid sequence analysis of the apoxin I showed close similarity to L-amino acid oxidase from the Malayan pit viper (Calloselasma rhodostoma). The purified apoxin I oxidized L-leucine but not D-leucine to produce H2O2. The apoxin I-induced apoptosis was inhibited by catalase, a H2O2 scavenger. These results indicate that the H2O2 produced by L-amino acid oxidation by apoxin I is involved in the apoxin I-induced apoptosis and in hemorrhage caused by rattlesnake venom.

Amino Acid Oxidoreductases↗
PubMed1997

Murine model of IgE production with a predominant Th2-response by feeding protein antigen without adjuvants.

Stimulation of systemic antigen-specific IgE production plays an important role in the mediation of food allergy; however, the mechanism of IgE production against food antigens is not fully understood. The development of relevant animal models may help to elucidate the pathogenesis of food allergy. We here show that DBA/2 mice receiving a casein diet without any adjuvant produced high levels of IgE specific for casein, accompanied by predominant Th2-like responses in liver lymphocytes, mesenteric lymph node cells and spleen cells. This model of IgE production produced by feeding protein antigen as a constituent of the diet can be applied to investigate the mechanism of IgE production and to develop reagents for controlling food allergy.

Animals↗
PubMed1997

Vascularized pedicle bone-grafting for nontraumatic avascular necrosis of the femoral head. A 5- to 11-year follow-up.

We investigated the results of 31 hips in 26 patients with nontraumatic (n = 20) and steroid-induced (n = 6) avascular necrosis of the femoral head (ANFH) treated with vascularized iliac pedicle bone graft (PBG). The average age at operation was 38.3 years. Three were women and 23 men. The average follow-up was 8.0 years. The Harris hip score prior to operation and at latest follow-up improved from 62 to 83; one hip collapsed and was revised with a bipolar endoprosthesis. At the final follow-up, 19 hips (63%) were clinically rated as good to excellent, 4 fair, and 7 poor. At the final follow-up, 15 of 27 hips (56%) of stage II before operation showed progressive collapse after bone grafting. In steroid-induced ANFH, in three women, 2 of 4 hips showed poor results. These results are only slightly better than those of core decompression and no better than those obtained after decompression and simple nonvascularized grafts to provide support for the subchondral bone. We concluded that vascularized PBG is sometimes indicated for ANFH in an early stage before collapse of the femoral head.

Adult↗
PubMed1997

Allergenic activity of heated and ovomucoid-depleted egg white.

BACKGROUND: No egg white products have been clearly proven to be hypoallergenic. The role of egg white proteins in allergic reactions to eggs is still debatable. OBJECTIVE: This study was designed to determine the importance of ovomucoid, an egg white protein, in the development of allergies to egg white. METHODS: We performed a double-blind, placebo-controlled food challenge in subjects with high levels of IgE antibodies for egg white to compare the allergenicities of heated and ovomucoid-depleted egg white, freeze-dried egg white, and heated egg white. Levels of IgE antibodies for egg white, ovomucoid, ovalbumin, ovotransferrin, and lysozyme were measured in serum by RAST. RESULTS: Twenty-one of 38 subjects with positive challenge responses to freeze-dried egg white had negative challenge responses to heated egg white, whereas 16 of 17 subjects (94.1%) with positive responses to heated egg white did not respond to the heated and ovomucoid-depleted egg white challenge. The subjects with positive challenge responses to freeze-dried egg white tended to have higher IgE antibody values to ovomucoid than those with negative responses. IgE antibody levels to ovomucoid were significantly higher in subjects with positive responses to a challenge with heated egg white than in those with no response. There were no significant differences in the levels of IgE antibodies to the other proteins, except ovomucoid, in the negative-response and positive-response groups in challenge tests with freeze-dried and heated egg white. CONCLUSION: The heated and ovomucoid-depleted egg white preparation was less allergenic than heated or freeze-dried preparations. Ovomucoid has a more important role in the pathogenesis of allergic reactions to egg white than other proteins in egg white.

Allergens↗
PubMed1997

Clinical results of cultured epithelial cell grafting in the oral and maxillofacial region.

Cultured epithelium has proven to be a good grafting material for skin defects. In our experience two kinds of epithelial cells, skin keratinocytes and mucosal cells, have been used to fabricate cultured epithelial sheets and autografted to the patients. Traumatic scars of the face were treated by cultured epidermal epithelium (CEE). The skin graft in the oral cavity was replaced by mucosa using cultured mucosal epithelium (CME). Also, the CME was applied to the skin defects at the donor sites of split-thickness skin grafts. Postsurgical follow-up showed good results. As a result, CME was useful in improving the biological environment around the abutments of dental implants, and it also promoted the re-epithelialization of skin defects. From our investigations, CEE/CME are promising treatment modalities which can reduce pain and speed up the healing process in burn patients. Therefore, cultured epithelium banks are worth establishing for auto- and allografting of skin/mucosal defects.

Adult↗
PubMed1997

Evaluation of heparin-binding growth factors in rescuing morphogenesis of heparitinase-treated mouse embryonic lung explants.

In vitro development of embryonic mouse lung explants was hindered by digestion with heparitinase, which removed about 40% of [35S] sulfate-labeled heparan sulfate synthesized. The enzyme-treated explants were inhibited in branching morphogenesis and the mesenchymal tissue was thin. Addition of basic fibroblast growth factor (bFGF), a typical heparin-binding growth factor, restored the inhibition caused by heparitinase in branching morphogenesis. Addition of midkine (MK), another heparin-binding growth factor, showed a weak effect on branching morphogenesis, but exhibited an effect in restoring development of mesenchymal tissue. These data together with the distribution of the factors indicate that both are involved in development of the lung. Heparitinase-treated explants can be useful models for evaluating roles played by various heparin-binding growth factors.

Animals↗
PubMed1997

The omental flap with skin grafting for treatment of a difficult sternal closure.

A case report of difficult sternal closure is described. Chest closure following cardiac operation in critically ill patients can be a problem. Techniques have been described so that sternal closure can be delayed until the patient is hemodynamically stable and hemostasis has been achieved. However, in some instances, the sternal closure can not be performed because of prolonged cardiopulmonary instability. We describe the use of transposition of an omental flap with skin grafting in a 74-year-old patient with aortic valve stenosis, poor pulmonary function, and a thoracic deformity. This technique enabled incomplete sternal closure which maintained hemodynamic stability.

Aged↗
PubMed1997

Midkine, a retinoic acid-inducible heparin-binding cytokine in inflammatory responses: chemotactic activity to neutrophils and association with inflammatory synovitis.

Midkine (MK) is a retinoic acid-inducible heparin-binding cytokine. In the inflammatory synovitis of rheumatoid arthritis and osteoarthritis, MK was detected in synovial fluid, synoviocytes, and endothelial cells of new blood vessels. Normal synovial fluid and noninflammatory synovial tissue did not contain detectable MK. Therefore, MK showed inflammation-associated expression in these cases. Furthermore, MK was found to promote chemotaxis of neutrophils in the range of 10 ng/ml. The mode of action of MK was found to be haptotactic; the substrate-bound form of MK was the active one. MK is also known to promote fibrinolysis. These activities of MK are in agreement with the modes of MK expression in various pathological statuses, and thus MK is proposed to be an important molecule regulating inflammatory responses.

Adult↗