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Biomedical subjects

T Kondo

Publications and source records attributed to T Kondo.

At least 901 records · Page 50Linked to original sources
PubMed1994

Experimental study of lung transplantation from non-heart-beating donor following brain death in canine model of left lung allotransplantation.

Thirty mongrel dogs were divided into 3 groups. Group I was a normal control group (n = 4) without transplantation procedure. Group II was a transplantation control group (n = 5) with left lung allotransplantation from heart-beating donor. Group III consisted of animals (n = 8) which received lung allografts from non-heart-beating donor following brain death. In Group III, brain death was brought about by intracranial hypertension with the inflation of balloon in the subdural space of donor. After 6 hours, the mechanical ventilation was discontinued followed by cardiac arrest. Left lung was excised twenty minutes after the cardiac arrest and was washed out with cold Ep4 solution for subsequent orthotopic allotransplantation. Right pulmonary arterial occlusion test (RPAO) were carried out under right thoracotomy to evaluate graft function immediately and 7 to 14 days after the surgery. PaO2, PAP and CO were measured before and 20 minutes after RPAO. All animals in Group II and 7 of 8 animals in Group III survived more than 7 days after surgery. No significant differences in the value of PaO2, mean PAP and TPVR with RPAO among three groups at each time of assessment, showing the possibility of lung transplantation from non-heart-beating donor followed by brain death.

Anesthesia↗
PubMed1994

Ultrasound guided endoscopic neurosurgery--new surgical instrument and technique.

For minimal invasive endoscopic neurosurgery, a mini-caliber endoscope equipped with a useful working channel and its guidance system is basically essential. We developed the device for ultrasound guided endoscopic neurosurgery. A minicaliber fiberscope with an outer diameter of 3.4 mm equipped with 2.5 mm of working channel for forceps, suction, and coagulation probe was developed. A 5 MHz phase arrayed 12 mm ultrasound probe was used as guidance system. A fixation device for the mini-caliber fiberscope and ultrasound probe was also constructed. The surgical procedure is very simple, and can be performed through a 2 cm burr hole. Real-time and a directly visualized image might provide more safety and reliability during brain surgery.

Brain Diseases↗
PubMed1994

A novel gene-transfer technique mediated by HVJ (Sendai virus), nuclear protein, and liposomes.

There have been many reports of in vivo direct gene transfer methods, but there are problems with these methods. Recently, we developed a novel, nontoxic and efficient in vivo direct gene transfer method mediated by Sendai virus (HVJ) and liposomes. In our system, foreign genes and nuclear proteins were encapsulated into the same liposomes, which were then treated with inactivated HVJ. The properties of our system are that HVJ enables foreign genes to be introduced directly into the cytoplasm by membrane fusion and that nuclear proteins transport the foreign genes rapidly into the nuclei. In the present study, we succeeded in introducing and expressing the functional gene for human insulin, and we observed the expression of this gene in mouse plasma and the reduction of plasma glucose. Our system will provide a new method of gene transfer aimed at postnatal gene therapy in various diseases.

Analysis of Variance↗
PubMed1994

The design of oral sustained-release theophylline dosing after conversion from intravenous to oral therapy.

We studied the design of oral sustained-release theophylline dosing after conversion from constant aminophylline infusion. Twelve children with bronchial asthma (9 boys and 3 girls) were evaluated in this study. Each patient received a constant intravenous administration of aminophylline for 4-10 days. Three hours after conversion from constant aminophylline infusion, they received oral sustained-release theophylline twice daily at 12-hour intervals. Blood samples were obtained at least once during the aminophylline infusion, just before conversion from the aminophylline infusion, and 0, 3 and 6 hours, and 4-5 days after administering oral theophylline. Pharmacokinetic parameters were estimated using the serum theophylline concentrations that were obtained during constant aminophylline infusion. These estimates of pharmacokinetic parameters were used to predict the serum theophylline concentrations during oral theophylline therapy. Predicted serum theophylline concentrations using individual pharmacokinetic parameters were fitted with actual measured values in this study. When switching a patient from intravenous aminophylline to sustained-release oral theophylline, the use of Bayesian analysis of serum theophylline concentration values obtained during intravenous therapy works well in predicting serum theophylline concentrations and in determining oral dosages that maximize the drug's effectiveness.

Administration, Oral↗
PubMed1994

[Effect of free radicals on the permeability of the blood brain barrier--using in vitro blood brain barrier model of human-SOD transgenic mouse].

Free radicals have been implicated in pathogenesis of vasogenic edema caused by post-ischemic reperfusion injury. It has been reported that Cu-Zn superoxide dismutase transgenic mouse (tg-mouse) which is overexpressing Cu-Zn SOD, prevents post ischemic brain edema and decreases infarct size in middle cerebral artery occlusion model. To investigate the effects of free radicals and free radical scavengers on the permeability of the blood-brain barrier (BBB), we established in vitro BBB model, using cultured brain endothelial cells (BECs) which were extracted from the tg-mice and non tg-mice (control). To make the BBB model, the BECs were cultured on the membrane which has 0.45 micron pores. After cells became confluent, the electrical resistance across the cell monolayer, which reflects the para-cellular flux of ionic molecules, was measured. The BBB model of the tg-mouse were incubated with menadione (Vitamin K3, intracellular O2- producting agent), and the segmental changes of the electrical resistance through the monolayer were compared with those of the control. Moreover, to investigate the effect of the ironic ions which influence the metabolism of free radicals, desferroxamine mesylate (Fe chelating agent) was added to the BBB models before menadione treatment. The cultured brain endothelial cells of tg-mouse has 1.7 times higher SOD activity than that of the control. In the menadione treatment, it showed a significant decrease of electrical resistance in the tg-mouse earlier than that of the control.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1994

[Migrating radiculopathy--an unusual complication of systemic lupus erythematosus in an HTLV-1 carrier].

We reported a 54-year-old HTLV-I seropositive female patient with systemic lupus erythematosus (SLE), who developed migrating radiculopathy but without chronic progressive myelopathy. She occasionally noticed butterfly rash and photosensitivity of the skin as well as painful episodes in different joints for 10 years. She developed pins and needles sensation on her trunk a few days after she experienced lumbago with abrupt onset. Neurological examinations revealed normal muscular strength, exaggerated deep tendon reflexes without Babinski signs, and dysesthesia on her upper extremities and the trunk. The latter symptom showed a segmental distribution of spinal nerve roots. And during the course of the disease, it migrated in accord with a radicular pattern. This sensory disturbance was fairly responsive to corticosteroid treatment. The spinal tap yielded clear cerebrospinal fluid (CSF) which showed mononuclear pleocytosis (16/mm3) with predominance of CD8+ cytotoxic cells and a positive result for anti-HTLV-I antibody. A neurological status deteriorated in parallel with non-neurological symptoms as SLE, when the patient had discontinued corticosteroids in a tapering course by herself. We postulate that HTLV-I infection in this patient modulated original autoimmune reactions as SLE, which led to manifestation of migrating radiculopathy possibly due to autoimmunity against ganglion cells. This is, to our knowledge, the first report of migrating radiculopathy in an SLE patient associated with HTLV-I infection.

Carrier State↗
PubMed1994

Accelerated exon skipping of IRF-1 mRNA in human myelodysplasia/leukemia; a possible mechanism of tumor suppressor inactivation.

The transcription factor IRF-1 has been shown to function as a tumor suppressor. Here we report that a significant proportion of the IRF-1 mRNA detected in normal human hematopoietic cells and cultured cell lines lacks exon 2 (containing the AUG initiation codon) and 3 as a result of exon skipping. Surprisingly, when we examined the bone marrow and peripheral mononuclear cells from patients with myelodysplastic syndrome (MDS) or leukemia secondary to MDS, we could still detect the exon-skipped form but little or none of the intact IRF-1 mRNA. This appears to be the result of accelerated exon skipping since we could find no mutations within the exons and splicing junctions from these patients. The exon-skipped form of IRF-1 lacking exons 2 and 3 displayed neither DNA binding nor tumor suppressive activities. Thus this accelerated exon skipping may cause the inactivation of IRF-1 and thereby contribute to the development of human hematopoietic malignancies.

Cell Line↗
PubMed1994

[Present situation in self-injection therapy with interferon-alpha for patients with renal cell carcinoma].

Interferon-alpha (IFN alpha) is often used for the treatment of renal cell carcinomas. The injections are frequently self-administered at home. To assess how this therapy was accepted by the patient we sent out a questionnaire. For the past 2 years until March 1993, this therapy was performed in our department on 52 patients, of whom 45 were selected for the study. All patients were informed of their disease and consented to the necessity of this treatment. Thirty-eight patients answered this questionnaire. Almost all patients injected this agent mainly by themselves. These findings suggested that they regarded this therapy as a strategy to be executed by themselves for the treatment of carcinoma. The main toxic symptoms in this therapy were asthenia, fever and loss of appetite. Leukocytopenia occurred in about half of the patients, of whom 1 patient required medication because of a rapid decrease in the white blood cell count shortly after inception of this therapy. The treatment was discontinued in 50% of the patients because of these adverse effects. Systemic toxicity disappeared after cessation of IFN alpha administration. Additionally, over 80% of the patients expressed concern about effectiveness, the duration and high cost of this therapy. The patients had to be repeatedly instructed about the method of disposing used needles and syringes. This study revealed that self injection of IFN alpha, which required strict management particularly at the initiation, can be performed at home. However, countermeasures must be taken against the side actions and an optimum regimen of IFN alpha should be established as soon as possible.

Adult↗
PubMed1994

[A 46-year-old man with cardiac failure and statues epileptics].

We report a 46-year-old man with bacterial endocarditis and cardiac failure, who developed status epileptics. The patient was apparently well until July of 1991 when there was a gradual onset of fever and general fatigue. He was hospitalized to the cardiology service of our hospital where diagnosis of bacterial endocarditis and aortic insufficiency was made. On October 9, 1991, he suddenly developed cardiogenic shock, and emergency replacement of the aortic valve was made; at the operation, the main trunk of the left coronary artery showed embolic occlusion, and the myocardial movement was markedly diminished; serum creatine kinase was 3.150 IU/l. His cardiac failure did not resolve, and renal failure developed in December 1991, for which peritoneal dialysis was necessary. On February 2, 1992, he suddenly developed a clonic seizure which started from his face with a transient post-ictal left hemiparesis; a cranial CT scan was unremarkable. He was treated with phenytoin and glycerol, however, he developed status epileptics on February 3; he developed cardiac arrest after the injection of phenytoin 750 mg. He was resuscitated, however, his status did not resolve. Neurological consultation was asked on February 4. On physical examination, his blood pressure was 80/40 mmHg heart rate 77/min and regular, and body temperature 39.1 degrees C. The palpebral conjunctiva were slightly anemic, however, the bulbar conjunctiva were not icteric. No cervical adenopathy was noted. Glade II systolic murmur was heard in the apex; the lungs were clear. The abdomen was flat and soft without organomegaly. No edema was present in the legs. On neurologic examination, he was comatose without response to painful stimuli. He repeatedly had convulsion lasting for 30 seconds every 2 to 3 minutes; his convulsions started with the conjugate deviation of the eyes to the left followed by turning of the head toward left, and then clonic convulsions started in this left upper limb extending to other extremities. The optic fundi were unable to visualize because of corneal clouding; light reflex was sluggish on the right side; no oculocephalic response was elicited; corneal reflex was also lost bilaterally. Extremities were hypotonic, and no automatic movement was seen. The triceps brachii reflex was diminished, but all the other deep reflexes were lost; no plantar response was elicited. Meningeal sign was absent. He was treated with intravenous diazepam; the interval of convulsions prolonged, however, blood pressure dropped to 40 to 40 mmHg. On February 4, intravenous thiopental anesthesia was instituted, and assisted respiration was started.(ABSTRACT TRUNCATED AT 400 WORDS)

Brain↗
PubMed1994

[A 54-year-old man with generalized muscle atrophy and oculomotor paresis].

We report a 54-year-old man with progressive generalized muscle atrophy and ophthalmoparesis in the terminal stage. He was well until 44 years of age (1982) when he noted weakness in his right hand and muscle atrophy; in May of 1985, he noted weakness in his left hand and in both legs. His weakness had become progressively worse, and he became unable to walk in November of 1985. He noted dysarthria one month later, and dysphagia in March of 1986. His difficulty in swallowing had also become worse; he regurgitated foods into the trachea in September of that year, and he developed a low grade fever on the same day. He was admitted to our service on September 24, 1987. On physical examination, general findings were unremarkable, except for low grade fever (37.3 degrees C). On neurologic examination, he was alert and mentally sound. He had normal vision and visual fields; ocular movements were normal. He had moderate weakness in facial muscles, dysarthria, dysphagia, and atrophy in his tongue. He had marked generalized muscle atrophy with fasciculation. He was unable to stand or walk. His muscle strength was not more than 1/6 in any part. The lower extremities were spastic. Deep reflexes were exaggerated in both lower extremities but were normal in upper extremities. Sensation was intact. Laboratory examination was unremarkable, and so was the cranial CT scan. He was treated with nasogastric feeding. He was able to communicate smoothly using his eyes, but a restriction in the vertical gaze was noted in February of 1989. The range of ocular movement was better in the oculocephalic reflex compared with his spontaneous vertical eye movements. In April of 1990, his horizontal gaze also had become slow, and he was complicated by bronchial asthma. He was treated with 20 mg/day of prednisolone; after the institution of prednisolone, his horizontal eye movement showed much improvement. In the terminal stage, he was able to move his eyes only very slowly; vertical gaze was impossible. His subsequent course was complicated by respiratory tract infection and septicemia, and he expired on July 15, 1992. The patient was discussed in a neurological CPC, and the chief discussant arrived at the conclusion that this patient had amyotrophic lateral sclerosis with oculomotor paresis. Post-mortem examination revealed spongy change involving the posterior column and the posterior spinocerebellar tract, in addition to severe degenerative change in the upper and the lower motoneurons, which were consistent with amyotrophic lateral sclerosis.(ABSTRACT TRUNCATED AT 400 WORDS)

Amyotrophic Lateral Sclerosis↗
PubMed1994

[Lung transplantation from non-heart-beating donor following brain death in canine model].

Candidates for pulmonary transplantation have been limited because of extreme susceptibility to lung infections and pulmonary edema in the brain-dead donor. To ameliorate the donor shortage, two possibilities for expanding the donor source have been presented, i.e. xenotransplantation and transplantation from cardiac-dead donors. The present study was conducted to evaluate the possibility of lung transplantation from a non-heart-beating donor following brain death, using a canine model. Six mongrel dogs were put into a state of brain death by elevating intracranial pressure with a balloon catheter. Following the intravenous administration of methylprednisolone and heparin used for 6-hour management following brain death mechanical ventilation was discontinued leading to cardiac arrest with in a few minutes. Excision of the left lung was scheduled for twenty minutes after cardiac arrest, followed by washing out the pulmonary vasculature with cold Ep4 solution, and orthotopic transplantation into the recipient animal. Immunosuppression was achieved with methylprednisolone and azathioprine. A right pulmonary arterial occlusion test (RPAO) was performed to assess graft function immediately and 7 days postoperatively. All but one animal survived and three animals had an uneventful postoperative course, with the transplants alone according to immediate and 7 day postoperative, respectively, RPAO results. These outcomes indicate the possible feasibility of lung transplantation from non-heart-beating donors following brain death.

Animals↗
PubMed1994

Various aspects of motor fluctuations and their management in Parkinson's disease.

Major motor fluctuations in patients with Parkinson's disease during levodopa treatment include "wearing-off" fluctuations, "on-off" fluctuations, freezing, and early morning dystonia. Other fluctuations, such as drug resistant "off periods," complicated "end-of-dose" effects and "resistant fluctuators" can also occur. In this paper, the underlying pathophysiologic mechanisms of the major motor fluctuations are reviewed, and practical approaches to manage these problems are discussed. "Wearing-off" fluctuations are most common, and several different mechanisms appear to be operating, including the interference of food in the gastrointestinal absorption of levodopa, inhibition of transport of levodopa to the brain by large neutral amino acids or 3-O-methyldopa, and progression of the degeneration of dopaminergic nerve terminals. The mechanisms of "on-off" fluctuations and freezing are not well understood. Loss of cerebral noradrenaline that results from locus coeruleus degeneration may, in part, be responsible for freezing. To minimize the occurrence of these motor fluctuations, multiple classes of antiparkinsonian drugs need to be used, so that the dose of levodopa can be maintained at a reasonably low level.

Dyskinesia, Drug-Induced↗
PubMed1994

[Classification of hyperlipidemia in a worksite population in Japan using criteria of the U.S. National Cholesterol Education Program].

Hyperlipidemia is an important risk factor of arteriosclerotic diseases. In Japan, as heart disease and cerebrovascular disorders rank second and third as the causes of death, demand has intensified for measures to prevent these diseases. In the U.S., the National Cholesterol Education Program (NCEP) was initiated as a means to prevent CHD by reducing th prevalence of hypercholesterolemia. Since 1988, this program has demonstrated effectiveness in this regard. In Japan, there are no consistent guidelines for the management of hyperlipidemia such as are espoused by the NCEP. In this study, in an endeavor to resolve this problem, a worksite population (1343 adult males) was classified according to the NCEP guidelines and the role and effectiveness of NCEP in this population were studied. A questionnaire concerning life-style and some biochemical findings were also used to classify the subjects according to the NCEP guidelines. Of the subjects, 22.8% were classified as hypercholesterolemic (> or = 240 mg/dl) and another 34.9% as being borderline high risk (> or = 200 < 240 mg/dl). Twenty-five percent of subjects required diet or drug therapy. The percentage of subjects requiring therapeutic intervention increased with age. The therapy group subjects tended to have a larger number of risk factors compared to the normal group. They also featured a significantly high age-adjusted odds ratios for hypertension, diabetes mellitus, obesity, and elevated serum triglyceride. This study suggests that in the health management of those in the therapy group, educational instruction on coronary risk factors is required.

Adult↗
PubMed1994

Long-term results of trabeculotomy ab externo.

We retrospectively reviewed the records of patients followed for over 4 years after undergoing trabeculotomy to treat primary open-angle glaucoma (POAG) to evaluate the long-term effects of the procedure on intraocular pressure (IOP) control. IOP remained below 15 mm Hg, with no need for postoperative medication in 7 (13.2%) of 53 eyes. IOP was below 15 mm Hg in an additional eight eyes (15.1%) treated with topical medication. Topical medication was needed to maintain IOP between 16 to 20 mm Hg in 23 eyes (43.4%). Oral acetazolamide or additional surgery was needed in 15 (28.3%). A postoperative IOP below 20 mm Hg with or without topical medication was associated with a survival probability of 71.2%. Our results demonstrated that, although trabeculotomy largely failed to maintain an "ideal" postoperative IOP (below 15 mm Hg), it was not associated with severe operative or postoperative complications such as flat anterior chamber. Thus, the procedure probably should be the first choice not only in uncomplicated cases of congenital glaucoma and pseudoexfoliation glaucoma (as previously established), but also in cases of POAG in young patients with only slight damage to the optic disc or visual field and cases with forward movement of the iris-lens diaphragm.

Adult↗