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Biomedical subjects

T Harada

Publications and source records attributed to T Harada.

At least 1,423 records · Page 79Linked to original sources
PubMedDate not supplied

Endoscopic injection sclerotherapy with ligation versus endoscopic injection sclerotherapy alone in the management of esophageal varices: a prospective randomized trial.

BACKGROUND/AIMS: Endoscopic injection sclerotherapy with ligation is a technique by which endoscopic injection sclerotherapy is first carried out for a target esophageal varix using an endoscope equipped with a device for endoscopic variceal ligation, and subsequently, endoscopic variceal ligation is performed for the varix together with the injection site of the sclerosing agent. The aim of this prospective, randomized trial was to compare endoscopic injection sclerotherapy with ligation with endoscopic injection sclerotherapy techniques in utility for patients with esophageal varices. METHODOLOGY: Twenty-four patients with esophageal varices who were to undergo either an elective treatment of bleeding esophageal varices or a prophylactic treatment of non-bleeding esophageal varices underwent endoscopic injection sclerotherapy with ligation (n = 12) or without ligation (n = 12). The patients were followed for a mean of 19.9 +/- 8.1 months in the endoscopic injection sclerotherapy with ligation (EISL) group and 19.5 +/- 5.4 months in the Endoscopic injection sclerotherapy (EIS) group. RESULTS: The red color sign disappeared in 10 patients in the EISL group and 3 in the EIS group (P = 0.004) after initial treatment. The length of time required for initial treatment was 16.3 +/- 4.7 min for the EISL group and 27.2 +/- 6.2 min for the EIS group (P = 0.0003). For treatment-related complications, no significant difference was noted between the 2 groups and no serious complication were noted in the 2 groups. The total quantity of ethanolamine oleate used to attain the endpoint was 17.3 +/- 7.9 mL for the EISL group and 25.2 +/- 9.7 mL for the EIS group (P < 0.05). The cumulative non-relapse rate for 2 years following attainment of the endpoint [F1, RC(-)] was 81.5% for the EISL group and 47.5% for the EIS group, producing no significant difference between the 2 groups. The cumulative non-bleeding and survival rates were 100% in the 2 groups. CONCLUSIONS: Endoscopic injection sclerotherapy with ligation is more useful for esophageal varices than endoscopic injection sclerotherapy alone.

Aged↗
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Sucrose incubation increases freezing tolerance of asparagus (Asparagus officinalis L.) embryogenic cell suspensions.

The freezing tolerance of asparagus (Asparagus officinalis L.) embryogenic cells, as determined by electrolyte leakage, was increased by the incubation of samples in medium containing 0.8 M sucrose. To elucidate the mechanism involved, we investigated the changes in soluble carbohydrates, cell ultrastructure and proteins accompanying the increase in freezing tolerance following incubation in sugar-rich medium. During sugar incubation, the intracellular sucrose content increased from 67 mol g-1FW to 429 mol g-1FW; it was also metabolized into fructose and glucose, as determined by high-performance liquid chromatography. Microscopy revealed that sugar incubation induced plasmolysis of embryogenic cells and drastic changes in cell ultrastructure with the appearance of rough endoplasmic reticulum (rER). Furthermore, immunoblotting analysis with anti-dehydrin antiserum revealed that a dehydrin-like protein appeared only when maximal freezing tolerance was induced by sugar incubation. These results suggest that freezing tolerance of asparagus embryogenic cells is increased by a complex mechanism involving notably changes in cell ultrastructure and accumulation of certain sugars and proteins during sugar incubation.

Asparagus Plant↗
PubMedDate not supplied

Mucoepidermoid carcinoma of the salivary glands: immunohistochemical distribution of intermediate filament proteins, involucrin and secretory proteins.

Mucoepidermoid carcinomas of the salivary gland comprising low (n = 6), intermediate (n = 11) and high grade malignant (n = 11) tumors were evaluated for immunohistochemical reactivity of cytokeratin (monoclonal antibody KL1, PKK1, K8.12), vimentin, involucrin and secretory proteins (lysozyme, LY; lactoferrin, LA; alpha 1-antitrypsin, alpha 1-AT and alpha 1-antichymotrypsin, alpha 1-Ach). Keratin expression was usually confined to intense staining in epidermoid tumor cells, but was negative in almost all mucous cells. Vimentin was coexpressed with keratin only in epidermoid tumor cells. Great heterogeneity of intermediate filament proteins was found in intermediate and epidermoid tumor cells. Involucrin in epidermoid tumor cells was particularly abundant in well keratinized cells but was lacking in intermediate and mucous forming cells. The frequency of occurrence of positive staining for LY, LA, alpha 1-AT and alpha 1-Ach was relatively low in mucoepidermoid carcinoma with positive immunohistochemical staining for these secretory proteins in mucous forming tumor cells, while varying expression was observed in epidermoid tumor cells.

Antibodies, Monoclonal↗
PubMedDate not supplied

Low-dose thoracic epidural anesthesia induces discrete thoracic anesthesia without reduction in cardiac output.

The sensory spread and hemodynamic effects of low-dose thoracic epidural anesthesia were closely studied in 13 elective preoperative patients undergoing thoracotomy. An epidural catheter was inserted at the T4-5 or T5-6 intervertebral space and 5 ml 0.5% plain bupivacaine was injected. Cardiac output was measured by suprasternal Doppler method in all patients and also by thermodilution method with a Swan-Ganz catheter in six subjects. The cardiac outputs measured by suprasternal Doppler (Y) and thermodilution (X) methods showed a high correlation (Y = 0.74X + 0.99, r = 0.90, n = 24). Cephalad and caudad levels of hypesthesia at 15 minutes after bupivacaine injection were C8.4 +/- 2.1 (mean +/- SD) and T7.8 +/- 2.6, and those of anesthesia, T1.9 +/- 2.4 and T5.7 +/- 2.6, respectively. After epidural injection of 0.5% plain bupivacaine, a mean decrease in heart rate of 12 was observed in 15 minutes, which while clinically insignificant, was statistically significant (p less than 0.001). The decreased heart rate returned to control level after endotracheal intubation. Mean arterial blood pressure decreased slightly and only a slight elevation was seen after endotracheal intubation. Cardiac index and pulmonary capillary wedge pressure were essentially unchanged during the study period. Central venous pressure increased gradually and significantly, but within the normal range. Pulmonary vascular resistance slightly decreased in 15 minutes and returned to the control level after endotracheal intubation. Thus, low-dose thoracic epidural anesthesia was associated with minimal cardiovascular changes.

Aged↗
PubMedDate not supplied

Technique for procurement of heart, liver and kidneys from a single donor for transplantation.

The purpose of this report is to present a safe, simple technique for procurement of the heart, liver, and kidneys from a single donor with no warm ischemic time. Twenty mongrel dogs were divided into 5 groups of 3 recipients and 1 donor each. Liver and kidney mobilization was performed when the core temperature of the liver reached 27 degrees C, a result of ice slush in the abdominal cavity. As the core temperature of the liver reached 20-22 degrees C, the aorta and inferior vena cava were clamped just above the diaphragm. After excision of the liver and kidneys, another team harvested the heart as it continued to beat. The heart and liver were transplanted orthotopically after simple preservation for 12 and 6 hours, respectively. The kidney was transplanted heterotopically after simple 12-hour preservation. The maximum survival time was 7 hours for heart transplantation and 16 days for liver transplantation. Kidney homogenate ATP levels decreased to 19% of baseline after preservation and were restored to 68% one hour after reperfusion. Our method is simple and safe for harvesting the heart, liver, an kidneys for transplantation and may offer a definite possibility for clinical application.

Animals↗
PubMedDate not supplied

Simultaneous retrieval of the heart and liver from a single donor: an evaluation through preservation and transplantation.

The simple, safe, and feasible procurement technique for the heart and liver with no warm ischemic time is reported. Fifteen mongrel dogs were used to form two recipients and one donor combination in each experiment. A midline incision is extended from the suprasternal notch to the pubis, and a catheter is advanced into the aortic root by means of the brachiocephalic artery for monitoring systemic arterial pressure and later for coronary vascular washout with a cold cardioplegic solution. Liver mobilization is carried out first when the core temperature of the liver reaches 27 degrees C, obtained with ice slush in the abdominal cavity. As the core temperature of the liver reaches 20 degrees to 22 degrees C, the aorta and inferior vena cava are clamped just above the diaphragm. After excision of the liver a second team harvests the heart while it continues to beat. The heart and liver were transplanted orthotopically after simple preservation into a cold solution for 12 and 6 hours, respectively. The maximum survival time was 7 hours in heart transplantation and 16 days in liver transplantation. Our method is a simple, safe, feasible technique for acquiring the heart and liver or other visceral organs for transplantation and may have broad clinical application.

Adenosine Triphosphate↗
PubMedDate not supplied

Gastric acid hypersecretion in short bowel syndrome in infants: association with extent of resection and enteral feeding.

To determine the frequency of gastric acid hypersecretion in infants with chronic malabsorption due to short bowel syndrome, acid secretory function was determined in 23 infants with malabsorption 2-22 months following small bowel resection and in a control group of 14 chronically ill, age- and weight-matched infants who did not undergo bowel resection. The prevalence of basal acid hypersecretion (defined as acid output 2 SD above the mean for the control group) was 17% (4 of 23). Basal gastric acid hypersecretion was associated with two factors: massive small bowel resection and initiation of enteral feeding. Basal acid hypersecretion was present on the initial study in 3 of 7 infants with less than one-third of the small bowel remaining, but in only 1 of 16 with more than one-third intact (p less than 0.05). Hypergastrinemia was present in 3 of 6 infants following massive bowel resection, but in only 1 of 15 with more than one-third intact (p less than 0.05), but hypergastrinemia was not consistently associated with hypersecretion. In each of six previously unfed infants, a trial of enteral feeding resulted in increased basal and maximal acid output. Three infants developed basal acid hypersecretion during initiation of enteral feeding. There was no evidence of pentagastrin-stimulated maximal acid hypersecretion in any of the infants.

Enteral Nutrition↗
PubMedDate not supplied

Vitamin D metabolism in biliary atresia: intestinal absorptions of 25-hydroxyvitamin D3 and 1,25-dihydroxyvitamin D3.

In children with biliary atresia, defective intestinal absorption of vitamin D and impaired hepatic uptake and 25-hydroxylation of vitamin D lead to a deficiency of vitamin D and rickets. We recently observed severe rickets in a 3-year-old boy with corrected biliary atresia resulting in jaundice, despite oral treatment with 1 alpha-hydroxyvitamin D3 (1 alpha-OHD3) or 1,25-dihydroxyvitamin D3 [1,25-(OH)2D3]. He had low 25-hydroxyvitamin D (25-OHD) and high 1,25-(OH)2D serum levels. Intramuscular vitamin D2 administration produced radiological and biochemical evidence of recovery. Oral 1,25-(OH)2D3 (0.1 microgram/kg) and 25-OHD3 (10 micrograms/kg) tolerance tests were done to assess the ability to absorb vitamin D and the effectiveness of using these drugs orally. Eleven children with corrected biliary atresia, aged 9 months to 7 years, were studied. In oral 1,25-(OH)2D3 tolerance tests, the increments above the baseline serum levels of 1,25-(OH)2D were 140.7 +/- 27.4 pg/ml in nonjaundiced patients (n = 5). In jaundiced patients (n = 3), 1,25-(OH)2D3 absorption in two patients with high basal 1,25-(OH)2D values was lower than that of nonjaundiced patients; however, the absorption in the third patient with a low basal value was similar to that of nonjaundiced patients. In oral 25-OHD3 tolerance tests, the mean increase of serum 25-OHD was 48.9 +/- 30.6 ng/ml in nonjaundiced patients (n = 5) and 23.7 +/- 9.5 ng/ml in jaundiced patients (n = 4), the peak serum 25-OHD levels being reached 6-12 h after 25-OHD3 loading.(ABSTRACT TRUNCATED AT 250 WORDS)

Biliary Atresia↗
PubMedDate not supplied

Effect of lipopolysaccharide of Haemophilus influenzae on ciliary activity of the human nasal mucosa and bullfrog palate clearance.

The influence of lipopolysaccharide (LPS) of Haemophilus influenzae on the ciliary activity of human nasal mucosa was first studied using both a photo-oscillographic apparatus and by bullfrog palate clearance. Neither modification of ciliary activity nor change in bullfrog palate clearance was observed in the early phase after the administration of LPS.

Animals↗
PubMedDate not supplied

Quantitative evaluation of pinocytosis of capillaries of the stria vascularis under normal and experimental conditions.

In order to examine evidence of high activity of pinocytosis in capillaries of the stria vascularis, quantitative morphometry of pinocytotic vesicles was carried out ultrastructurally by the horseradish peroxidase (HRP) tracer method. In guinea pigs, there was a significant difference between the stria vascularis and spiral ligament in the number of vesicles per micron 2 (p less than 0.05) and labelled vesicles per micron 2 (p less than 0.001). In normotensive control rats, the number of labelled vesicles per micron 2 in capillaries of the stria vascularis was significantly greater (p less than 0.001) than that of the spiral ligament. Results of acute hypertensive and acute hypotensive experiments both indicated that enhanced permeable capillaries of the stria vascularis showed no significant increase in the number of pinocytotic vesicles per micron 2, but that they showed a more significant increase in the number of labelled vesicles per micron 2 than non-enhanced permeable capillaries of the stria vascularis (p less than 0.01) and capillaries of the spiral ligament (p less than 0.001). These findings provide ultrastructural confirmation of our previous studies (4, 8, 9) that pinocytosis contributes to the high permeability of capillaries of the stria vascularis under normal and experimental acute hypertensive and acute hypotensive conditions.

Animals↗
PubMedDate not supplied

Dynamic tympanometry.

Tympanometry was performed under the contraction of the middle ear muscles (dynamic tympanometry). A tympanogram of lesser compliance was observed under a stapedius reflex which was produced by contralateral acoustic stimulation. In patients with reversed (downward) stapedius reflex, the dynamic tympanogram showed either a higher peak amplitude or a shift of conventional tympanogram to the negative pressure side. Voluntary contraction of the tensor tympani produced a lesser compliance with positive pressure, whereas there was an apparent increase of compliance with negative pressure in the external auditory meatus. A shift of the dynamic tympanogram to the negative pressure side was interpreted as being due to contraction of the tensor tympani muscle. Dynamic tympanometry may also be utilized as a recording of reflex decay.

Acoustic Impedance Tests↗
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Long-acting nicardipine for elderly hypertensive patients: effect on diurnal variation of blood pressure.

The effect of long-acting nicardipine tablets on diurnal variation of blood pressure was compared with that of standard nicardipine tablets and long-acting nifedipine tablets by 24-hour ambulatory blood pressure monitoring in 35 patients with hypertension. Long-acting nicardipine decreased systolic blood pressure in each age group, and there was no difference in its anti-hypertensive effect when compared with the other two drugs. All three drugs had no effect on the amplitude of daily blood pressure variation, and all three drugs decreased the baseline blood pressure in each age group when compared with untreated patients. In addition, no change was observed in the decrement of baseline blood pressure after switching from the other two drugs to long-acting nicardipine. Long-acting nicardipine had less effect on diurnal blood pressure variation than standard nicardipine tablets, which are administered three times daily. In each age group, long-acting nicardipine also more effectively inhibited the increase in cardiac work resulting from the morning rise phenomenon when compared with standard nicardipine tablets. These findings suggest that long-acting nicardipine may be a more useful preparation for the treatment of essential hypertension, particularly in elderly patients.

Aged↗
PubMedDate not supplied

Familial Creutzfeldt-Jakob disease: three autopsy cases of the panencephalopathic type.

Three autopsy cases of panencephalopathic type of familial Creutzfeldt-Jakob disease (CJD) were investigated. Cases 1 (51-year-old male) and 3 (54-year-old female) were siblings and Case 2 (68-year-old female) was their aunt. In cases 1 and 3, the age of onset (Case 1:51, Case 3:53), duration of illness (Case 1:9 months, Case 3:8 months) and neuropsychiatric symptoms (pyramidal and extrapyramidal tracts involvements, blindness and dementia in chronological order) were similar, but in Case 2, the onset was later (66 years old), duration was longer (32 months) and the initial symptom was dementia. Myoclonus and apallic state in the terminal stage were common to all 3 cases. Neuropathologically, all 3 cases had characteristics that indicated panencephalopathic type of CJD. Cases 1 and 3 had similar neuropathological findings with characteristic circumscribed necrotic foci in the subcortical white matter. In Case 2 in contrast, diffuse demyelination and fibrillary gliosis in the cerebral white matter were observed without circumscribed necrotic foci. In the cerebellum of Case 3, granular cell loss was very slight. The other lesions in the cerebral cortex and striatum of the 3 cases were common. In conclusion, the clinical symptoms and neuropathological findings of our familial CJD cases were different from one another.

Aged↗
PubMedDate not supplied

Neuro-Behçet disease with demyelination and gliosis of the frontal white matter.

A rare case of neuro-Behçet disease with diffuse demyelination and gliosis of the frontal white matter is reported clinico-pathologically. The disease began with genital ulcer and recurrent oral aphthosis when the patient was 42 years of age. There was erythema, moderate fever, CSF (cerebrospinal fluid)-pleocytosis and elevated CSF-globulin. He was diagnosed as having neuro-Behçet disease and treated with prednisolone. He gradually became euphoric, disinhibited, indifferent and demented. His cranial CT showed diffuse low density areas in the bilateral frontal white matter. He became bedridden, akinetic mute and died from respiratory dysfunction 3 1/2 years after onset. The following neuropathological findings were observed: 1) Moderate demyelination and gliosis was present mainly in the frontal and parietal white matter. 2) There were many micro-spongious necrotic foci in the gray and white matters of the cerebrum, basal ganglia, thalamus, midbrain and pons, some of which were accompanied by gliosis. 3) From 1/2 to 1/3 of all micro-necrotic foci in the frontal white matter were old and accompanied by gliosis. The white matter containing numerous micro-necrotic foci had myelin pallor and gliosis. 4) There was neither micro-necrosis nor gliosis in the occipital lobe. The pathogenetic correlation of white matter lesions with primary and secondary circulatory disturbances is discussed.

Atrophy↗
PubMedDate not supplied

Surgical management of large hepatocellular carcinomas: criteria for curative hepatectomy.

This study was designed to determine the criteria for curative resection in hepatectomy for large hepatocellular carcinoma. The extent of resection was closely related to recurrence rate, and complete removal of the involved segments was found to be essential for curative hepatectomy. Patients with satellite nodules had a high incidence of recurrence; in fact, carcinoma recurred in all patients, with satellite nodules scattered through more than one segment, despite whole tumor removal. However, curative resection could be achieved in patients with portal involvement confined to the second portal branches, when the tumor, including tumor thrombi, was removed en bloc. On the basis of these results, we define complete en bloc removal of the involved segments, including portal involvements, as curative resection, even though curative hepatectomy is not attainable in patients with satellite nodules in more than one segment and/or tumor thrombi in the first branches or truncus of the portal vein.

Carcinoma, Hepatocellular↗
PubMedDate not supplied

Effects of glutathione isopropyl ester on bile flow in glutathione-depleted rats.

Combined administration of buthionine sulfoximine (2.5 mmol/kg, i.p.) and diethyl maleate (1.0 ml/kg, i.p.) resulted in a near-complete depletion of hepatic glutathione (0.02 mumol/g liver vs 5.17 mumol/g in saline-treated controls) in male Sprague-Dawley rats. Bile flow was markedly reduced in the rats as compared with the controls and glutathione was not detected in the bile. The linear regression of the correlation between bile flow and endogenous bile-acid excretion rates revealed that no bile acid-independent bile flow was produced in the glutathione-depleted rats. The bile flow was partially restored by an intravenous infusion of glutathione isopropyl ester (1.17 mmol/kg/hr). Glutathione levels were increased in the bile (16 nmol/kg/min) and in the liver (0.55 mumol/g) at the end of the 100 min infusion period of the ester. The increments in bile flow rates were not proportional to the biliary excretion rates of bile acids or glutathione, and the flow rates suddenly increased when glutathione levels in the bile reached an apparent threshold. The increments, not accompanied with an excretion of diethyl maleate-glutathione conjugate, were much greater than expected from the osmotic choleresis of glutathione in the bile. These results indicate that hepatic glutathione above a certain level is required for the formation of a portion of bile flow, and that an intravenous administration of glutathione isopropyl ester is effective in partially restoring the bile formation impaired by glutathione depletion.

Animals↗
PubMedDate not supplied

Local control of prostate cancer with transurethral intracavitary radiation therapy.

As of January 1986, 13 patients with adenocarcinoma of the prostate had been treated in our clinic by remote after-loading transurethral high dose rate radiotherapy using a 60Co source. Of these patients, four were at stage B2, three at stage C, three at stage D1, and three at stage D2. The mean total dose of transurethral radiotherapy was 35.2 Gy to the most distant prostatic capsule from the source. Three patients with stage D1 disease and one patient with stage C disease received additional external radiation with a total dose of 20 Gy to the prostate and 40 Gy to the pelvis. Local tumor response proved rapid and satisfactory as verified by rectal examination, ultrasonography, and needle biopsy. Serious complications such as proctitis, cystitis, incontinence, and urethral stricture were not evident during the average follow-up term of 34.9 months.

Adenocarcinoma↗