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T Oda

Publications and source records attributed to T Oda.

At least 253 records · Page 14Linked to original sources
PubMed1996

Epidemiologic application of pulsed-field gel electrophoresis to an outbreak of Campylobacter fetus meningitis in a neonatal intensive care unit.

An outbreak of nosocomial Campylobacter fetus meningitis occurred in a neonatal intensive care unit (NICU). Eight C. fetus strains were isolated from 4 infants with meningitis, the mother of the index patient and 2 infants who were asymptomatic intestinal carriers. The pulsed-field gel electrophoresis (PFGE) pattern with the restriction endonucleases Smal and Sall were found to be identical for the nosocomial C. fetus isolates, but the patterns were different from those of sporadic strains. These nosocomial strains were strongly suspected to be a single strain. The finding revealed that the index patient was infected by the mother, and that the outbreak developed from this patient by cross-infection. This is the first confirmed nosocomial C. fetus meningitis outbreak spread by cross-infection in a NICU.

Adult↗
PubMed1996

Plasma and urinary metabolites of efonidipine hydrochloride in man.

1. The plasma and urinary metabolite profiles of efonidipine hydrochloride, a new dihydropyridine calcium antagonist, have been examined in six healthy male volunteers after oral dosing. 2. Unchanged drug in plasma was determined by hplc-ms. Five metabolites in plasma and five metabolites and unchanged drug in urine were identified by hplc. 3. The main plasma metabolites were N-dephenylated-efonidipine and deaminated-efonidipine. 4. No significant amount of unchanged drug was excreted in urine. In the urine collected for 24 h after a oral dosing, 1.1% of the dose was excreted as deaminated-efonidipine, and 0.5% as a pyridine analogue of deaminated-efonidipine.

Adult↗
PubMed1996

[Preanesthetic evaluation of cardiovascular reserve in a patient with dilated cardiomyopathy].

We described an anesthetic management of a patient with abdominal aortic aneurysm associated with dilated cardiomyopathy (DCM) focusing on preanesthetic evaluation of cardiovascular reserve and on intraoperative continuous circulatory monitoring with transesophageal echocardiography (TEE) and continuous cardiac output measurement (CCO). Based on echocardiographic and hemodynamic measurements after a 50 m-walk load, we predicted the allowable range of alteration of preload (LV diastolic dimension; Dd), myocardial performance (arterial blood pressure and ejection fraction) and of heart rate. During anesthesia and operation, we continuously monitored Dd, arterial blood pressure, heart rate and cardiac output, and maintained these variables within the allowable range. The changes in preload after clamping or unclamping of the aorta was promptly reflected by Dd as compared to pulmonary capillary wadge pressure. The CCO was also usuful in detecting abrupt changes in myocardial performance. In conclusion, we suggest preanesthetic stress test to be performed to evaluate cardiovascular reserve and to predict the allowable range of alteration of hemodynamic variables. Continuous monitoring of preload (Dd) by TEE and of myocardial performance by CCO is useful to detect early changes in these variables.

Anesthesia, General↗
PubMed1996

Superoxide dismutase activity in arthropathy: its role and measurement in the joints.

The electron spin resonance (ESR) method was used to measure the superoxide dismutase (SOD) activity in synovial fluids from the knee joints of 73 patients with rheumatoid arthritis (RA), and the results were compared with those of 50 patients with osteoarthritis (OA) and posttraumatic arthritis (PA). The SOD activity in RA and OA knee joint fluids was higher than in the control patients with PA. Patients with moderate RA (grade III or IV according to Larsen's classification of rheumatoid knee radiographs) showed higher SOD activities in joint fluids than patients with early (grade I or II) and terminal (grade V) stages of RA. Our results suggest that the SOD activity in joint fluids is a valid index of articular destruction and repair.

Adult↗
PubMed1996

[Targeted chemotherapy of hepatocellular carcinoma using Lipiodol as a carrier].

For targeted chemotherapy using Lipiodol as a carrier, it was found that anticancer agents had to be dissolved in Lipiodol and diffused gradually from it. Dose forms having properties for targeted chemotherapy were named "oily anticancer agents". Oily anticancer agents are completely different from simple mixture of Lipiodol and anticancer agents by pumping methods in antitumor activities and adverse effects. Up to 1,601 arterial injections of oily anticancer agents were given to 400 patients with unresectable hepatocellular carcinoma. Decrease in serum AFP levels was observed in 209 (94%) of 222 AFP-positive patients, and reduction of tumor size was observed in 308 (96%) of 322 patients who had evaluable tumors. Reduction in size to less than 50% was observed in 50% of patients 5 to 6 months after initial administration, and all tumors reduced to less than 50% one year after. In 45 of 60 patients whose tumors shrank to less than 10% of initial size, follow-up 1 year or more after tumor shrinkage could be done (range 1-9 years, average 3 years). These tumors did not regrow, so they were considered to be cured. Survival was prolonged, especially in 251 patients who were good candidates for therapy (excluding those with Child C liver cirrhosis, tumor occupying all four segments of the liver, and/or extrahepatic spread at initial arterial injection of the drug), the 1-, 2-, and 5-year survival rates were 83, 58, and 34%, respectively.

Adolescent↗
PubMed1996

Role of neutrophil elastase in the development of renal necrotizing vasculitis.

To assess the pathogenetic mechanisms of renal vasculitis, we performed immunohistochemical studies using renal biopsy specimens which were obtained from a patient with microscopic polyangiitis during both the acute and the convalescent phase. Intense infiltration and aggregation of neutrophil elastase positive (NE+) cells were observed especially in the periglomerular and perivascular areas in the first biopsy in which vascular necrosis, rupture of Bowman's capsule, and necrotizing glomerulonephritis were present. In addition to intracellular NE expression, NE was also expressed extracellularly in both segmental glomerular tufts and the interstitium. Intensity of NE immunoreactivity in the glomeruli was closely correlated with the development of glomerular necrotizing lesions and crescents, but no such correlation was detected with the infiltration of macrophages, T cells or B cells. In the second biopsy (convalescent phase), patchy intracellular NE expression was present in the interstitium, but no aggregation of NE+ cells or extracellular NE expression was detected in either the glomeruli or the interstitium. These findings suggest that recruitment of polymorphonuclear leukocytes in perivascular and periglomerular areas as well as in glomerular tufts, and subsequent extracellular release of NE in situ may play an important role in the development of renal vasculitis characterized by vascular necrosis, rupture of Bowman's capsule, and tuft necrosis.

Biopsy, Needle↗
PubMed1996

[Usefulness of scheduled IABP for CABG].

We examined the usefulness of intra-aortic balloon pumping (IABP) before the coronary arterial bypass grafting (IABP) before the coronary arterial bypass grafting (CABG) in patients with severe ischemic heart disease. Left main trunk (LMT) disease, unstable angina and low ejection fraction (less than 40%) were indications for scheduled IABP. Eleven patients underwent IABP before CABG surgery (the scheduled IABP group), and five patients didn't before CABG surgery (the unscheduled IAPB group). Analysis comprised the duration of IABP and mortality. There were no significant differences between the two groups in age, pre-operational cardiac index, ejection fraction, aorta clamp time or total perfusion time. IABP application times were significantly longer in the unscheduled IABP group than in the scheduled IABP group (p < 0.05). No death occurred in the scheduled group, but three patients in the unscheduled group died (p < 0.05). No complications were observed due to IABP in any patient of either group. We conclude that scheduled IABP is useful for patients with severe ischemic heart disease.

Aged↗
PubMed1996

[Trial of home infusion therapy for near-terminal stage patients with lung cancer].

To improve the quality of life in patients with malignant diseases at the near-terminal stage, we established a system for home infusion therapy (HIT) in Osaka Prefectural Habikino Hospital in 1994. Thirty-three patients were taken care of at home using the HIT system from January, 1995 to May, 1996. Their average age was 70 years old. The duration of HIT varied from 1 to 105 days (mean:25.5 days). Twenty-four cases received parenteral nutrition. The others received agents for brain edema (4 cases), morphine hydrochloride (2 cases), and anti-fungal agents (3 case). Additionally, 63% of these patients required home oxygen therapy (HOT) with HIT. Questionnaires to their families revealed that they were afraid of the progress of the disease in patients and their physical burden became heavier after the start of HIT. However, they were quite satisfied with the results of HIT.

Adolescent↗
PubMed1996

[A case of report of traumatic aortic regurgitation accompanying cerebral embolism].

Aortic regurgitation due to nonpenetrating trauma of the chest is an extremely rare disease and only 12 cases have been reported in this country. We report a case we treated and present additional of retrospective discussions. The patient was a 59-year-old man who lost consciousness due to a heavy blow to the chest during work. He was diagnosed as having acute aortic regurgitation. A close examination on the 3rd day after the injury revealed cerebral embolism and heart failure could not be controlled by physical treatment. Surgery was performed on the 5th day after the injury. The aorta was incised under cardiopulmonary bypass to examine aortic valves. Commissures between the RCC and the NCC and between the NCC and the LCC had been torn from the aortic wall and injured and thrombus adhesion was observed in a part of the NCC. After repairing the aortic wall, the valve was replaced by SJM valve. Postoperative course is satisfactory.

Aortic Valve↗
PubMed1996

[Nephrotic syndrome related to chronic graft versus host disease after allogeneic bone marrow transplantation in a patient with malignant lymphoma].

A 13-yr-old boy was diagnosed as T cell lymphoma. After the second remission, he underwent BMT from an HLA-identical, MLC negative sibling donor. After BMT, he developed grade II acute GVHD. GVHD was improved by pulsed steroid therapy using prednisolone. About 12 months after BMT, he developed bronchiolitis obliterans, sicca syndrome, and leukoderma, which were related to chronic GVHD. Pulsed steroid therapy was carried out twice, and his condition improved. Twenty-seven months after BMT, he developed nephrotic syndrome. A renal biopsy was performed, and the diagnosis was histologically membranous nephropathy and focal glomerular sclerosis. The response to steroids was not satisfactory. After 5 weeks, dipyridamole was added, but proteinuria persisted. Proteinuria disappeared 8 weeks after the addition of cyclosporine. The second biopsy after 5 months of treatment revealed an improvement in the renal lesions. The patient showed a low T4 to T8 ratio of T-lymphocytes at the onset of nephrotic syndrome. However after treatment with cyclosporine, the ratio gradually increased. These findings suggested the nephrotic syndrome in this patient was related to renal involvement in the course of chronic GVHD.

Adolescent↗
PubMed1996

Long-term effects of intensive therapy combined with tonsillectomy in patients with IgA nephropathy.

IgA nephropathy (IgAN) is the most common form of glomerular disease in the world. However, there is currently no established therapy for IgAN. To assess treatment regimens for IgAN, we investigated a retrospective long-term follow-up study comparing an intensive therapy with a conventional therapy. Clinical outcomes 5 years after the initiation of treatment in two centers were compared. In one center, patients were treated with tonsillectomy combined with steroid pulse, cyclophosphamide, anti-platelet drugs and warfarin (intensive therapy group, Group A, n = 50). In the other center patients were treated with anti-platelet drugs, warfarin or no treatment (conventional therapy group, Group B, n = 50). At the beginning of treatment, the two groups were well matched in terms of age, sex, blood pressure, urinalysis, and creatinine clearance. Five years after the initiation of treatment, proteinuria was remarkably reduced from 1.6 g/day to 0.5 g/day in Group A, whereas no significant change in proteinuria was observed in Group B. Creatinine clearance significantly improved from 77.6 ml/mm to 89.4 ml/min in Group A, whereas creatinine clearance deteriorated from 70.9 ml/min to 62.5 ml/min during 5 years in Group B. Our results indicate that early intensive therapy for IgAN is potentially of great value, and warrants close investigation.

Adult↗
PubMed1995

Identification of two human sequence-specific DNA-binding proteins which interact with the direct repeats in the squirrel monkey retrovirus long terminal repeat.

Squirrel monkey retrovirus (SMRV) is a xenotropic endogenous virus of the squirrel monkey. The long terminal repeat of the SMRV contains four direct repeats (43 or 42 bp) with different degrees of perfection in the U3 region. Herein, we found two human nuclear proteins (SMBP1 and SMBP2) which bind specifically to the direct repeats with different affinities. The binding proteins recognize overlapped sequences in the 5' region of the repeats. SMBP1 and 2 are monomeric proteins of 35 and 17 kDa, respectively.

Animals↗
PubMed1995

Embryonal craniopharyngioma. Case report of the morphogenesis of a craniopharyngioma.

BACKGROUND: Ordinary craniopharyngiomas affecting sellar regions of children and preadolescents are composed of ameloblastomatous and/or squamous constituents. The authors encountered an autopsy case of a stillborn infant with a large craniopharyngioma with unusual manifestations. METHODS: The craniopharyngioma was analyzed using detailed histologic and immunohistochemical techniques. RESULTS: An autopsy revealed a large tumor arising from the pituitary gland with associated severe hydrocephalus. Histologically, the cells of the tumor showed features of ameloblastoma and organoid structures simulating tooth buds and adenohypophyseal primordia in the stage of organogenesis. Cells of the latter were shown to be immunoreactive for chromogranin A and six adenohypophyseal hormones. CONCLUSIONS: Because embryology of the adenohypophysis and the teeth indicated that all of the epithelia in this tumor emerged during the normal development of the stomodeum, it was believed that an "embryonal form of craniopharyngioma" would characterize this organoid neoplasm best. The possible morphogenesis of craniopharyngioma is also discussed.

Adult↗
PubMed1995

Natural course of cervical spine lesions in rheumatoid arthritis.

STUDY DESIGN: This study analyzed the natural course of cervical spine involvement in rheumatoid arthritis by serial radiographs. OBJECTIVES: The purpose was to determine the pattern of progression of cervical spine lesions in rheumatoid arthritis and predictors for the extent of progression. SUMMARY OF BACKGROUND DATA: Subluxation frequently occurs as a result of rheumatoid involvement of the cervical spine. It may be severe in patients with mutilans deformities in the hands and feet. The extent of progression in a given patient is still unpredictable. METHODS: Serial cervical radiographs in 49 patients with rheumatoid arthritis were analyzed. The extent of progression was evaluated by rheumatoid arthritis subset defined previously, which reflected the final extent of joint erosion in this systemic disease and could be roughly classified during early stages of the disease. RESULTS: In the upper cervical spine, reducible anterior atlantoaxial subluxation occurred first. Vertical subluxation of the axis appeared next. Irreducible change of preceding anterior atlantoaxial subluxation was a sign of the start of vertical subluxation. In subaxial lesion, subluxation occurred less frequently (22.4%) than upper cervical lesion (77.6%). The extent of progression was different with the rheumatoid arthritis subset. In the upper cervical spine, none of the subset with least erosive disease developed vertical subluxation, whereas 52% of the subset with more erosive disease and 88% of the subset with mutilating disease advanced to vertical subluxation. The extent of progression was well correlated with the number of joints with erosion. Subaxial subluxation was often seen and became irreducible in mutilating disease and more erosive disease, but not in least erosive disease. CONCLUSIONS: A progressive pattern of the upper cervical subluxations was clarified. That is, upper cervical lesions progressed from reducible anterior atlantoaxial subluxation to irreducible anterior atlantoaxial subluxation with vertical subluxation. This extent of progression was different with the rheumatoid arthritis subset, which was also related to the development of subaxial subluxation. The most aggressive arthritis classification, a subset with mutilating disease, had the more severe subluxation in both upper and subaxial cervical spine.

Adolescent↗
PubMed1995

[Clinical assessment of brain oxygen metabolism and function during cardiopulmonary bypass with induced hypothermia].

This study was designed to demonstrate the changes in brain metabolism/function, and to clarify the reason for assessing brain dysfunction during cardiopulmonary bypass (CPB) with systemic hypothermia. Fifteen patients, who received high-dose fentanyl anesthesia, for cardiac surgery under CPB were analysed concerning systemic hemodynamics, brain oxygen extraction, internal jugular venous oxygen saturation (SjVO2), glucose uptake, and compressed spectral array EEG for brain function. Internal jugular venous temperature decreased from 35.4 +/- 1.0 degrees C (mean +/- SD) at pre-CPB, to 22.3 +/- 1.6 degrees C during CPB. Systemic oxygen delivery decreased by 43% (P < 0.01) with coincided decrease in brain oxygen extraction by 31% (P < 0.01) during CPB. SjVO2 rose from 64.5 +/- 6.3% of pre-CPB level to 78.7 +/- 2.2% during CPB (P < 0.01). Glucose uptake decreased 71% during CPB (P < 0.01). EEG frequency slowed down from 9.0 +/- 0.6 Hz of pre-CPB level to 3.5 +/- 0.3 Hz during CPB (P < 0.01). No patient showed neurological complications during and after surgery. The predictable changes in the variables during brain ischemia/hypoxia may be increase in oxygen extraction, decrease in SjVO2, inhibition of metabolism and low EEG activity. During CPB, EEG activity exhibited identical trend as during ischemia/hypoxia, while the changes in brain oxygen extraction and SjVO2 did not. In conclusion, detection of brain dysfunction by monitoring brain oxygen metabolism or EEG is controversial during CPB using hypothermia.

Aged↗
PubMed1995

[Effects of allopurinol on renal damage following renal ischemia].

We investigated the effects of allopurinol on renal damage following renal ischemia. Male Wistar rats weighing 250-300 g were classified into enflurane and allopurinol groups and anesthetized for 5 minutes using 1.7 MAC of enflurane in 30% oxygen. Then the left renal artery was dissected and clamped. Arterial occlusion was performed under 1.3 MAC enflurane for 30 minutes. Anesthesia was maintained for an additional 90 minutes after releasing the clip. In the allopurinol group, the rats were administered with allopurinol 3 mg.kg-1 intravenously prior to renal ischemia. At the end of anesthesia and 24 hours after the discontinuation of anesthesia, the necrotic areas, kidney weight/body weight ratios, gamma-GTP and NAG activities of the kidney which had been clamped were examined. Urinary gamma-GTP and NAG activities and serum inorganic fluoride concentrations were also measured. The necrotic area was significantly smaller in the allopurinol group than in the enflurane group. The activity of gamma-GTP in the kidney was higher in the allopurinol group than in the enflurane group. The kidney weight/body weight ratio was lower in the allopurinol group than in the enflurane group. There was no difference in serum inorganic fluoride concentration between the allopurinol and enflurane groups. These results suggest that allopurinol decreases renal damage following renal ischemia under enflurane anesthesia.

Allopurinol↗
PubMed1995

Ceramide reverses brefeldin A (BFA) resistance in BFA-resistant cell lines.

We have found that C6 ceramide, a cell-permeable ceramide analog, partially restored the brefeldin A (BFA) sensitivity in a BFA-resistant mutant of Vero cells (BER-40) and in the naturally BFA-resistant Madin-Darby canine kidney (MDCK) cells. Incubation of BER-40 and MDCK cells with low concentrations of C6 ceramide resulted in (i) a pronounced increase in BFA cytotoxicity as measured by the inhibition of [3H]thymidine incorporation and the inhibition of colony formation by BFA, (ii) a significant protection by BFA against ricin cytotoxicity, and (iii) an inhibition of bulk protein secretion by BFA in BER-40 and MDCK cells. Related sphingolipids including sphingosine, sphingomyelin, and lactosylceramide and other unrelated lipid second messengers such as arachidonic acid and 1,2-diacylglycerol did not elicit the protection of BER-40 and MDCK cells against ricin cytotoxicity by BFA. C6 ceramide was the most effective among the ceramides with different acyl chain lengths. Interestingly, dihydro-C6 ceramide, which lacks the trans double bond in the sphingoid base, had no effect. On the other hand, C6 ceramide did not enhance BFA sensitivity in BFA-sensitive Vero cells. The LD50 of C6 ceramide were similar in Vero and BER-40 cells. Fluorescence microscopic studies revealed that C6 ceramide induced the redistribution of beta-COP from the Golgi membranes to a more dispersed localization in both BFA-sensitive and BFA-resistant cell lines, mimicking the effect of BFA. Suboptimal concentration of C6 ceramide also restored the effect of BFA on the beta-COP distribution in BER-40 and MDCK cells. These results indicate that C6 ceramide restores the BFA sensitivity in BFA-resistant BER-40 and MDCK cells.

Animals↗