Biomedical subjects

T Katoh

Publications and source records attributed to T Katoh.

At least 91 records · Page 5Linked to original sources

PubMed2000

Adhesion of dermatophytes to healthy feet and its simple treatment.

At several public baths, we isolated dermatophytes from the soles of healthy volunteers by a new direct isolation method (foot-press culture method). We confirmed that a public bath is one of major sources of infection of dermatophytes. We showed that simple treatments such as (i) wiping the sole with a towel; (ii) washing with soap; (iii) 100 steps on another mat; and (iv) holding the foot up for an hour, significantly reduced the fungi on the soles of six healthy volunteers. These treatments may be effective for prevention of tinea pedis.

Adult↗

PubMed2000

Coronary risks after high-dose gamma-globulin in children with Kawasaki disease.

OBJECTIVES: The goals of the present study were to develop a predictive coronary risk scoring system after intravenous gamma-globulin (IVGG) therapy of any dose for the different preparations currently used in the treatment of children with Kawasaki disease and to determine the predictive value of the system. The previously reported scoring systems were based on treatment with high-dose IVGG therapy at limited doses and were determined using investigative methods. METHODS: Four hundred and fifty-one patients were randomized into one of three groups and received either i.v. polyethylene glycol-treated human immunoglobulin at a dose of either 200 (n = 147) or 400 mg/kg per day (n = 152) or freeze-dried sulfonated human immunoglobulin at 200 mg/kg per day (n = 152) for 5 consecutive days. We documented 31 cases of coronary abnormalities (CA). Univariate and multivariate logistic regression was performed using 49 clinical variables and the resulting predictive model was validated. RESULTS: The duration of fever (odds (I day)/odds (- 5 days)= 0.158; 95% confidence interval (CI) 0.0385-0.648), hemoglobin (odds (Q1 = 10.3)/odds (Q3 = 11.6) = 3.97; 95% CI 1.92-8.20), IgG (odds (Q1 = 1,900)/odds (Q3=2,658)=2.72, 95% CI 1.18-6.25) and IgA (odds (Q1 =72)/odds (Q3= 160) = 0.415; 95% CI 0.253-0.680) levels after completion of gamma-globulin infusion were independent predictors. The model is quasi-cross validated and has acceptable sensitivity and selectivity. The estimated risk and observed occurrence of CA coincide. CONCLUSIONS: Determinants of the risk of CA after IVGG therapy are a longer duration of fever, a lower IgG level, a higher IgA level and a lower hemoglobin level after IVGG infusion. This model is applicable for IVGG doses from 1 to 2 g/kg and for at least two different gamma-globulin preparations.

Child↗

PubMed2000

Apparent bradycardia-dependent sinoatrial block associated with respiration.

In our previous patients, apparent bradycardia-dependent block has been shown in the atrioventricular (AV) junction and in the accessory pathway. It was suggested that these previous cases were not of true bradycardia-dependent block; namely, that, as a result of periodic increases in vagal tone associated with respiration, conductivity in the AV junction or in the accessory pathway was depressed to a greater degree than automaticity in the sinus node. In the present article, 3 patients with frequent sinoatrial (SA) block were reported. In 1 patient, sinus escape-capture bigeminy caused by SA block was found. In these present patients, when the sinus cycle lengthened, SA block occurred. The purpose of the present article is to show that the patients have apparent bradycardia-dependent SA block, namely, not true bradycardia-dependent SA block. In all patients, the respiration curve was recorded simultaneously with the electrocardiogram. In all patients, during inspiration, the sinus cycle gradually shortened; on the other hand, during expiration, the sinus cycle gradually lengthened, and then a sinus impulse was blocked in the SA junction. These findings suggested that increased vagal tone during expiration depressed conductivity in the SA junction to a greater degree than automaticity in the sinus node.

Bradycardia↗

PubMed2000

Fentanyl augments block of sympathetic responses to skin incision during sevoflurane anaesthesia in children.

We studied 61 healthy ASA 1 patients (aged 2-6 yr) to determine if fentanyl affects the minimum alveolar concentration which blocks adrenergic responses to skin incision (MAC-BAR) in 50% of children in the presence of 60% nitrous oxide. Patients were allocated randomly to one of three fentanyl groups to receive 0, 2 or 4 micrograms kg-1. Patients also received sevoflurane at a preselected end-tidal concentration according to an 'up-and-down' design. After a steady-state sevoflurane concentration had been maintained for at least 15 min, fentanyl was given i.v. Skin incision was performed 5 min after administration of fentanyl. The response was considered positive if heart rate (HR) or mean arterial pressure (MAP) increased by 15% or more. The MAC-BAR of sevoflurane was 1.45 MAC (95% confidence intervals 1.25-1.65 MAC), and this was reduced markedly to 0.63 MAC and 0.38 MAC by addition of fentanyl 2 and 4 micrograms kg-1, respectively. A ceiling effect was not observed and there was a significant difference between the 2 and 4 micrograms kg-1 groups.

Adjuvants, Anesthesia↗

PubMed2000

Comparison of compound A concentrations with sevoflurane anaesthesia using a closed system with a PhysioFlex anaesthesia machine vs a low-flow system with a conventional anaesthesia machine.

Sevoflurane anaesthesia was conducted using a totally closed circuit PhysioFlex anaesthesia machine (PhysioFlex group) or with a standard Modulus CD anaesthesia machine (Modulus group) (n = 8 in each group). The PhysioFlex was used under closed system conditions and the Modulus was used under low-flow system conditions (flow rate 1 litre min-1). Concentrations of sevoflurane degradation products and the temperature of soda lime were compared. Degradation products in the circuit were measured hourly, and the temperature of soda lime was monitored. The only degradation product detected was CF2 = C(CF3)-O-CH2F (compound A). Maximum concentrations of compound A were significantly lower (median 8.5 (range 5.4-15.9) ppm) in the PhysioFlex than in the Modulus group (21.2 (16.5-27.4) ppm) (P < 0.05). The maximum temperature of soda lime was also significantly lower in the PhysioFlex group (35.3 (32.1-36.3) degrees C vs 44.6 (43.0-47.1) degrees C, respectively) (P < 0.05). Hourly compound A concentrations were lower in the PhysioFlex group than in the Modulus group. End-tidal sevoflurane concentrations during measurement of degradation products were not different between groups. Therefore, use of the totally closed PhysioFlex system may significantly reduce compound A concentrations compared with low-flow anaesthesia using a standard anaesthesia machine.

Adult↗

PubMed2000

The effects of prolonged low-flow sevoflurane anesthesia on renal and hepatic function.

UNLABELLED: We assessed the effects of prolonged low-flow sevoflurane anesthesia on renal and hepatic functions by comparing high-flow sevoflurane with low-flow isoflurane anesthesia. Thirty patients scheduled for surgery of > or =10 h in duration randomly received either low-flow (1 L/min) sevoflurane anesthesia (n = 10), high-flow (6-10 L/min) sevoflurane anesthesia (n = 10), or low-flow (1 L/min) isoflurane anesthesia (n = 10). We measured the circuit concentrations of Compound A and serum fluoride. Renal function was assessed by blood urea nitrogen, serum creatinine, creatinine clearance, and urinary excretion of glucose, albumin, protein, and N:-acetyl-beta-D-glucosaminidase. The hepatic function was assessed by serum aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase, alkaline phosphatase, and total bilirubin. Compound A exposure was 277 +/- 120 (135-478) ppm-h (mean +/- SD [range]) in the low-flow sevoflurane anesthesia. The maximum concentration of serum fluoride was 53.6 +/- 5.3 (43.4-59.3) micromol/L for the low-flow sevoflurane anesthesia, 47.1 +/- 21.2 (21.4-82.3) micromol/L for the high-flow sevoflurane anesthesia, and 7.4 +/- 3.2 (3.2-14.0) micromol/L for the low-flow isoflurane anesthesia. Blood urea nitrogen and serum creatinine were within the normal range, and creatinine clearance did not decrease throughout the study period in any group. Urinary excretion of glucose, albumin, protein, and N:-acetyl-beta-D-glucosaminidase increased after anesthesia in all groups, but no significant differences were seen among the three groups at any time point after anesthesia. Lactate dehydrogenase and alkaline phosphatase on postanesthesia Day 1 were higher in the high-flow sevoflurane group than in the low-flow sevoflurane group. However, there were no significant differences in any other hepatic function tests among the groups. We conclude that prolonged low-flow sevoflurane anesthesia has the same effect on renal and hepatic functions as high-flow sevoflurane and low-flow isoflurane anesthesia. IMPLICATIONS: During low-flow sevoflurane anesthesia, intake of Compound A reached 277 +/- 120 ppm-h, but the effect on the kidney and the liver was the same in high-flow sevoflurane and low-flow isoflurane anesthesia.

Acetylglucosaminidase↗

PubMed2000

Influence of age on hypnotic requirement, bispectral index, and 95% spectral edge frequency associated with sedation induced by sevoflurane.

BACKGROUND: Aging is associated with a reduction in anesthetic requirements. The effects of age on the electroencephalographic response to inhalational anesthesia have not been well documented. The objective of the present study was to determine the influence of age on hypnotic requirement and electroencephalographic derivatives such as bispectral index and 95% spectral edge frequency associated with sedation induced by sevoflurane. METHODS: Ninety-six patients were randomly allocated into one of three age groups A, B, and C, ranging in age from 18-39 yr, 40-64 yr, and 65-85 yr, respectively. Patients in each group were sedated with sevoflurane at two predetermined concentrations ranging between 0.45% and 0.85%. The relationship between sevoflurane concentration and response to a verbal command, as well as the relationships between response and bispectral index and 95% spectral edge frequency, was determined. RESULTS: Multiple regression analysis showed that end-tidal sevoflurane concentration and age significantly affected both bispectral index and 95% spectral edge frequency. ED50 values of sevoflurane concentration for loss of consciousness, defined as no response to verbal command, were different between groups A and C: 0.72 (95% confidence interval: 0.68-0.75) versus 0.59 (95% confidence interval: 0.56-0.62). However, the same effective values of bispectral index and 95% spectral edge frequency at this same clinical end point did not differ. CONCLUSIONS: Increasing age reduced sevoflurane requirements to suppress responses to a verbal command but did not change bispectral index and 95% spectral edge frequency associated with this end point, and in a population with a wide age range, bispectral index would predict depth of sedation better than end-tidal sevoflurane concentration.

Adult↗

PubMed2000

Relationship between NAT1 genotype and phenotype in a Japanese population.

NAT1, which biotransforms many carcinogens, is genetically polymorphic. This polymorphism has been postulated as a mechanism for susceptibility differences in cancer, possibly due to NAT1 activity differences. However, the relationship between NAT1 genotype and phenotype is not clear. In our study of 110 Japanese, the frequency of the NAT1*10 allele (0.53, 95% confidence interval 0.46-0.59) was higher than others have observed in Caucasians (0.16). From genotype frequency studies, 26.4% of the subjects belonged to the NAT1*10/*10 genotype, 53.6% to the NAT1*4/*10 genotype and 20% to the NAT1*4/*4 genotype. Neither NAT1*3 nor NAT1*11 genotype was seen in these subjects. In female subjects, we found higher NAT1 activity in NAT1*4/*10 subjects than in NAT1*4/*4 subjects (n = 49; 2.63 versus 2.16 nmol/min/mg protein). NAT1 activity-difference between NAT1*4/*10 and NAT1*10/*10 was not statistically significant. Thus, not only the presence of NAT1*10 allele, but also other factors are suspected of increasing NAT1 activities. After full sequencing of 10 subjects, five individuals having the highest activities and five individuals having the lowest activities, we found NAT1*18A and NAT1*18B to be in the high activity group and the low activity group, respectively. The genotypes containing these variants were heterozygous, i.e. NAT1*4/*18A and NAT1*4/*18B. Due to rare frequencies of these variants, they cannot be considered as other effective, genetic factors on NAT1 activity. Age and tobacco smoking did not affect the relationship between NAT1 genotype and phenotype.

4-Aminobenzoic Acid↗

PubMed2000

Urinary excretion of type IV collagen as a specific indicator of the progression of diabetic nephropathy.

AIMS AND METHODS: This study was carried out to clarify whether the urinary excretion of type IV collagen (u-IV collagen) detected by specific radioimmunoassay, can be used as an indicator for the progression of diabetic nephropathy. RESULTS: u-IV collagen was higher in diabetic subjects with microalbuminuria and overt proteinuria than those with normoalbuminuria, IgA nephropathy, membranoproliferative glomerulonephritis, membranous nephropathy, or control normal subjects. u-IV collagen was positively correlated with serum and urinary beta(2)-microglobulin and negatively with creatinine clearance only in diabetic patients, but not in patients with other glomerular diseases. The serum type IV collagen was not different between all the groups, and not correlated with its urinary excretion. In the advanced diabetic nephropathy, immunoreactive type IV collagen was detected in glomerular basement membrane (GBM), tubular basement membrane and Bowman's capsule much more than that in the normal kidney. CONCLUSION: These findings indicated increased production and degeneration of type IV collagen in diabetic nephropathy. It is suggested that augmented turnover of type IV collagen in GBM and tubular basement membrane results in increased concentrations of free u-IV collagen. Therefore, measurement of u-IV collagen may be a useful, specific indicator of the progression of diabetic nephropathy.

Adult↗

PubMed2000

Infective endocarditis with extensive calcified granulation of the mitral annulus and valve--a case report.

Mitral annular calcification, a degenerative process usually seen in the elderly or in chronic renal failure, is rarely seen in an extensive form. A 69-year-old man with no history of renal failure, rheumatic fever, or heart disease had mitral valve vegetation and regurgitation, together with extensive mitral annuls and valve calcification, which may or may not have been secondary to the infective endocarditis.

Aged↗

PubMed2000

Tyrosine-kinase dependent TGF-beta and extracellular matrix expression by mechanical stretch in vascular smooth muscle cells.

Vascular hypertrophy, which is characterized by proliferation of vascular smooth muscle cells (VSMC) and accumulation of extracellular matrix (ECM), is a major pathological change in blood vessels after chronic exposure to hypertension. Blood pressure is transmitted to the arterial walls and counterbalanced by mechanical stress, leading to stretching of circumferentially oriented VSMC, which may play some role in the pathogenesis of vascular hypertrophy. The present study was designed, therefore, to investigate the effect of mechanical stretch on the expression of ECM components and transforming growth factor-beta (TGF-beta), a potent stimulator for ECM production, and to examine the signal transduction mechanisms of the induction of TGF-beta in cultured rat VSMC. VSMC were subjected to cyclic stretch to provide a maximal elongation of 20% at a rate of 60 cycles per minute for up to 24 h. Mechanical stretch stimulated TGF-beta1 mRNA expression in a time- and elongation-dependent manner. Indeed, the secretion of TGF-beta proteins into the culture media was increased after stretch. Stretch also stimulated mRNA expression of the ECM components, type I and type IV collagen, and fibronectin, which was largely inhibited by addition of neutralizing antibody against TGF-beta. The tyrosine kinase inhibitors genistein and herbimycin A blocked the induction of TGF-beta1 and type I collagen by stretch, while protein kinase C inhibitors, the calcium channel blockers nitrendipine and gadolinium, or Ca removal from the media had no effect. These results suggest that stretch-induced, tyrosine kinase-mediated autocrine/paracrine production of TGF-8 may play a critical role in the progression of vascular remodeling associated with high blood pressure.

Animals↗

PubMed2000

[Preventive effects of various socks against adhesion of dermatophytes to healthy feet].

We studied the preventive effects of socks against dermatophyte infection. Wearing various socks (cotton socks, nylon stockings, wool socks and "tabi"), a healthy volunteer walked on a bath mat on which a patient with tinea pedis had stepped earlier. The volunteer pressed her right foot with socks onto large agar medium (Foot-press method), then, took off the socks and performed the Foot-press method again. The number of colonies of isolated dermatophytes on the medium was counted. The number of isolated colonies from the sole after taking off the nylon stockings was larger than that from the foot wearing the stockings. Dermatophytes were also isolated from the sole after taking off cotton socks. In contrast, few dermatophytes were isolated from the sole after taking off wool socks or "tabi". On microscopic observation, fibers of the nylon stockings and cotton socks were seen to be loose enough for dermatophytes to pass through. In contrast with those socks, fibers of wool socks and "tabi" were tight or fluffy. In conclusion, the nylon stockings and cotton socks are unsatisfactory in preventing the adhesion of dermatophytes.

Adult↗

PubMed2000

[Dose the serum brain natriuretic peptide (BNP) level after open heart surgery reflect myocardial protection?].

This clinical study was conducted to determine whether the serum BNP level after open heart surgery reflects myocardial protection. The levels of BNP and CPK-MB were measured before and after 12 hours of cardiopulmonary bypass, then 1, 3, and 6 days after open heart surgery, and the relationship between the maximum levels of BNP and the CPK-MB after open heart surgery was examined. The patients were divided into two groups according to whether or not the maximum CPK MB was more than 100 IU/l after open heart surgery. A significant relationship between the maximum BNP and the maximum CPK-MB after open heart surgery was observed (p = 0.013). Moreover, the BNP was significantly increased in the group of patients with a maximum CPK-MB > or = 100 IU/l, compared to that in those with a maximum CPK-MB < 100 IU/l, 12 hours 1 day, and 6 days after open heart surgery (p < 0.01). These findings indicate that the serum level of BNP after open heart surgery can reflect myocardial protection.

Adult↗

PubMed2000

[A questionnaire survey of the panel discussion at the annual meeting of the Japan Society of Anesthesiologists].

Two hundred questionnaire sheets were distributed to the audience of the panel discussion session titled "Progresses of balanced anesthesia" at the annual meeting of the Japan Society of Anesthesiologists. The audience was requested to rate their interest to the program and also rate the usefulness of the presentations by each panel. One hundred and seventeen questionnaire sheets (58%) were returned. Eighty five % of the returned survey expressed interests in the program. Forty three % expressed their interests in altering their anesthesia techniques along the line of the recommendation by the panels. These data suggest that the program met the educational need of the audience. Questionnaire survey may be useful in identifying the need of the members, and thus helpful in planning future meetings of the society.

Anesthesiology↗

PubMed2000

[Could apoptosis be contributed to the occurrence of aortic dissection?].

This clinical study was conducted to determine whether apoptosis is contributed to the occurrence of aortic dissection. The subjects comprised 11 patients who underwent Stanford type A aortic dissection and 4 autopsy cases, being the control group. The occurrence of apoptosis was determined by the TUNEL assay using an aortic wall specimen, and the distribution of macrophages and h-MMP-9 was examined by immunohistological staining. Apoptotic cells were observed in the aortic specimens for all of the 11 patients who underwent Standford type A aortic dissection, but not in any of the 4 autopsy cases. Moreover, apoptotic cells were present in large numbers on the surface of the false lumen strongly in 8 patients who underwent surgery within 1 month after aortic dissection, but not in 3 who underwent treatment after than 1 month. Those phenomena were also observed in the immunohistological staining of CD 68 and h-MMP-9. These findings indicate that apoptosis could be contributed to the occurrence of aortic dissection.

Aged↗

PubMed2000

[Resected case of thymic cyst with primary lung cancer].

Thymic cyst is a rare and benign tumor of mediastinal tumor. A 77-year-old male was pointed out the tumor shadow on Chest X-ray film and diagnosed lung cancer. On admission some examination was performed and revealed mediastinal tumor accidentally. Primary lung cancer was completely resected and mediastinal tumor was extirpated. Pathological examination revealed lung cancer (poorly differentiated squamous cell carcinoma) and thymic cyst. Many methods of examination were tried for diagnosis of thymic cyst, but couldn't diagnose exactly before its resection. Some of the patients with thymic cyst was reported to develop SVC syndrome or change to malignant tumor. Therefore we think complete resection is the best treatment.

Aged↗

PubMed2000

[Transurethral removal of the ureter by the intussusception method in the treatment of renal pelvic and ureteral tumors].

Between August 1986 and December 1998, 19 patients who had renal pelvic and upper ureteral tumors were treated with nephrectomy and transurethral removal of the ureter using the intussusception method. Removal of the ureter failed in 5 patients because of excessive ablasion of the ureter or insufficient electro-resection around the ipsilateral ureteral orifice. Excluding those patients, the safety of the operation and the intravesical recurrence were compared with the outcome in 12 patients undergoing partial cystectomy for similar tumors. The mean operating time was not significantly shorter with the intussusception method compared with partial cystectomy (190.4 versus 251.3 minutes), but the mean blood loss was significantly smaller (187.5 versus 460.2 ml) and the intussusception method did not require a blood transfusion. The mean term of hospitalization was 20.3 days for patients treated by the intussusception method which was significantly shorter than that for patient undergoing partial cystectomy (25.4 days). Intravesical recurrence was found in seven patients (50%) treated by the intussusception method and the 1- and 5-year recurrence-free rates were 69.2% and 30.8% respectively. There was no significant difference in the recurrence-free rates between the two surgical techniques. These results suggest that the intussusception method is superior to partial cystectomy in decreasing the operating time, blood loss and term of hospitalization. It can be an attractive option in selected cases, without increasing the risk of intravesical recurrence.

Adult↗

PubMed2000

[The compound A concentration in a low-flow anesthesia circuit using the new CO2 absorbent SPHERASORB].

CO2 absorbents convert sevoflurane to fluoromethyl-2,2-difluoro-1-(trifluoromethyl) vinyl ether (compound A), whose toxicity in rats raises concern regarding the safety of sevoflurane in a low-flow system. SPHERASORB is a new CO2 absorbent which does not contain KOH. However, the reaction between SPHERASORB and sevoflurane has not been examined. We compared compound A concentration in a model circuit using SPHERASORB and the commonly used Sodasorb II. The anesthesia circuit was circulated with fresh gas flow at a rate of 1 l.min-1 containing 2% sevoflurane. Compound A concentration was measured hourly and the temperature of CO2 absorbent was monitored. The maximum concentration of compound A in the circuit was 12.2 +/- 1.4 ppm for SPHERASORB and 18.6 +/- 0.4 ppm for Sodasorb II (P < 0.05). The maximum temperature of SPHERASORB was lower than that of Sodasorb II (P < 0.05). SPHERASORB can reduce compound A formation, compared to Sodasorb II.

Absorption↗