[Experience in the treatment of congenital dislocation of the hip joint in infants with the Riemengugel method].
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Female↗
Biomedical subjects
T Oda
Publications and source records attributed to T Oda.
Adenosine deaminase in plasma of patients with adult T-cell leukemia (ATL): correlation between enzyme activity and the ATL subtypes.
Adenosine deaminase (ADA) was assayed in plasma from 14 patients with adult T-cell leukemia (ATL) (eight with acute ATL and six with smoldering or chronic ATL), 20 male family members (ten were anti-ATLA antibody positive and the other ten negative), and 25 normal individuals. ADA activity was uniformly higher in plasma from patients with ATL than normal controls. This enzyme activity significantly increased in acute ATL in comparison to smoldering or chronic ATL. In families of ATL patients, no statistical difference in ADA activity between the anti-ATLA antibody-positive group and -negative group could be discerned. The enzyme activity in a patient with acute ATL, after a bone-marrow transplant, rapidly increased as leukemic cells increased in peripheral blood. These findings indicate that the levels of ADA activities in plasma from ATL patients reflect the condition of this disease. Thus, measurement of this enzyme activity offers a further parameter to distinguish subtypes of ATL, and is of prognostic and therapeutic value.
Adenosine Deaminase↗
Adenylate cyclase activation promotes the recruitment of coronary vasodilator reserve and improves subendocardial contractility during coronary hypoperfusion.
This study was designed to examine the effects of an adenylate cyclase activator, NKH477, on epicardial and endocardial contraction and coronary blood flow (CoF) in the presence or absence of ischemia and to compare it to those of adenosine. We measured coronary pressures (CoP), coronary blood flow, epicardial and endocardial wall thickening (i.e., %EPWT and %ENWT, respectively, by sonomicrometry) in 18 anesthetized dogs. The left circumflex coronary artery was perfused with arterial blood using a pressure controlled servo pump. Propranolol (0.5 mg/kg) and atropine (0.25 mg) were used to minimize the neurogenic effects. CoP decreased from 100 mm Hg to 40 mm Hg with and without drugs. At CoP of 100 mm Hg, intracoronary infusion of NKH477 (10(-8) M/kg/min) produced a two-fold increase in CoF, but there were no changes in either the %EPWT or the %ENWT. During coronary hypofusion at coronary pressures equal to 40 mm Hg, NKH477 increased CoF from 16 +/- 2 to 28 +/- 4 mL/min (p < 0.05) and improved %ENWT significantly from 6 +/- 7 to 23 +/- 7% (p < 0.05). However %EPWT was not improved by NKH477. On the other hand, the intracoronary infusion of adenosine (10 micrograms/kg/min) increased CoF from 16 +/- 5 to 21 +/- 6 mL/min (p < 0.05) at CoP of 40 mm Hg. However, this dose of adenosine failed to improve %ENWT (16 +/- 10% vs. 14 +/- 10%, n.s.). Thus, the improvement of subendocardial function by NKH477 might be related to the improvement of subendocardial perfusion which could be induced by the potentiation of endogenously released adenosine as well as the direct vasodilator effect. This contrasts with the effects of exogenously administered adenosine, which failed to improve subendocardial contractility.
Adenosine↗
Atrial natriuretic peptide messenger RNA and peptide in rats with aortic valve insufficiency.
To investigate ANP gene expression in diseased hearts of animals without genetic defects, immunoreactive ANP (IR-ANP) and ANP mRNA were measured in a rat with aortic valve insufficiency (AI), which was produced by puncturing one of the aortic valve leaflets with a plastic rod. Plasma IR-ANP concentration was higher in AI rats than in sham rats (p less than 0.05). Decreased atrial concentration of IR-ANP (p less than 0.05) and unchanged atrial ANP mRNA concentration were shown in AI rats. The ventricular concentrations of IR-ANP and ANP mRNA in AI rats were 5.4 and 2.4 times higher than those in sham rats (p less than 0.05, respectively). These results demonstrate that gene expression of ventricular ANP is markedly increased in AI rats while that of atrial ANP is not changed.
Animals↗
Application of a laryngeal mask to a fiberoptic bronchoscope-aided tracheal intubation.
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Adult↗
Effect of simple omentoplasty and omentopexy in the prevention of complications after pelvic lymphadenectomy.
This multicenter collaborative study prospectively evaluated the effect of omentoplasty and omentopexy on the prevention of complications after pelvic lymphadenectomy. Sixty-four consecutive patients (42 cervical and 22 endometrial cancer) were enrolled and examined periodically for 12 months. All patients underwent simple, semiradical, or Okabayashi's radical hysterectomy and complete pelvic lymphadenectomy. The infracolic omentum was longitudinally divided in half and omentoplasty was performed so that bilateral omental flaps would reach the pelvic floor. The omental flaps were inserted into the retroperitoneal space and the edges of the flaps were sutured to the psoas muscle. The omental flap was then covered by the peritoneum. Incidence of lymphocele, lymphedema, and severe complications associated with lymphocele, such as infection or urinary stenosis, was evaluated at intervals for at least one year after surgery. Among the 64 patients, 12 patients received pelvic radiation because of occult lymph node metastasis. Planned omentoplasty was not possible in one patient because her omentum was too small; therefore, only unilateral omentopexy was performed. Asymptomatic lymphoceles only were detected by ultrasonogram in 12 patients (18.8%). Three patients (4.7%) had a symptomatic but pressure-only lymphocele. Hydronephrosis and bladder compression probably due to lymphocele were observed in one patient, respectively (3.1%), but resolved within 6 months. Lymphedema was observed in seven patients (10.9%) and persisted for more than 6 months in two patients (3.1%). We conclude that this simple technique of omentoplasty and omentopexy appeared to be effective in reducing the incidence of complications after pelvic lymphadenectomy.
Adult↗
Pneumomediastinum, subcutaneous emphysema, and pulmonary fibrosis in a patient with idiopathic pneumonia syndrome after bone marrow transplantation.
An adolescent female underwent bone marrow transplantation for relapsed leukemia and developed acute and chronic graft-versus-host disease and idiopathic pneumonia syndrome. Her lung disease responded to large doses of methylprednisolone but evolved to pulmonary fibrosis and pneumomediastinum and subcutaneous emphysema in the convalescent period. Pulmonary function tests revealed a restrictive pattern. Pneumomediastinum and subcutaneous emphysema are complications not only of obstructive but also of restrictive lung disease and vary with respect to time of onset.
Acute Disease↗
Transplanted peripheral blood stem cells, mobilized by chemotherapy alone, can induce persistent hematopoiesis in children with acute leukemia.
Three patients with leukemia were transplanted with peripheral blood stem cells mobilized by intensification or maintenance chemotherapy alone. They maintained persistent reconstituted hematopoiesis for at least 9 years. The experience provides evidence that long-term marrow repopulating cells can be mobilized into the blood to an adequate repopulating extent by chemotherapy alone.
Adolescent↗
Skeletal muscle powered pumps can work under low preload. Design considerations.
Characteristics of a dual chambered, single layered skeletal muscle powered pump (DCSLP) and a single chamber, multilayered pump (SCMLP) made from similar masses of untrained latissimus dorsi muscle (LD) were compared. For the DCSLP, 16 canine LDs (51.5 +/- 1.6 g) were wrapped in a "figure eight" around two parallel mandrels, whereas for the SCMLP, LDs were made in 10 by wrapping the LD (54 +/- 8.5 g) twice around one mandrel. Chamber compliance and pump isovolumic peak developed pressure (PDP), stroke volume (SV), stroke work (SW), and ejection fraction (EF) of single contractions were measured. In six of the DCSLP dogs (LV), heart left ventricular stroke volume (LVSV) and left ventricular stroke work (LVSW) were determined. Stimulation parameters were the same for all. Student's t-test (* = p < 0.05) was used for statistical analysis. Dual chambered, single layered skeletal muscle powered pumps with a diastolic volume/mass ratio of 0.63 were more compliant than SCMLPs with a ratio of 0.37. Single chamber, multilayered pumps generated slightly higher PDP, but this was significant only at 60 mmHg preload. At a preload of 15 and an afterload of 120 mmHg, DCSLPs had higher SV (10.7 +/- 1.1 ml) and SW (0.98 +/- 0.14 x 10(6) ergs) than SCMLPs (6.8 +/- 0.7 ml* and 0.58 +/- 0.08 x 10(6) ergs*), or their LV counterparts (5.3 +/- 0.9 ml and 0.84 +/- 0.22 x 10(6) ergs).(ABSTRACT TRUNCATED AT 250 WORDS)
Animals↗
A compressive type skeletal muscle pump as a biomechanical energy source.
The purpose of this study was to assess the applicability of the conditioned latissimus dorsi muscle as an energy source for circulatory assist devices. The authors developed a pneumatic chamber as a muscle actuator. The pneumatic chamber placed between latissimus dorsi muscle and chest wall was compressed by the burst stimulated muscle and, thereby, converted muscle contractile power into pneumatic pressure. The authors report the performance of the implanted pneumatic chamber at a chronic phase, and the capability of the conditioned muscle in situ as an energy source for circulatory assist devices. Six adult mongrel dogs were used. At the first operation, a pacemaker for muscle conditioning and the pneumatic chamber were implanted. After 12 weeks of muscle conditioning, the performance of the pneumatic chamber with conditioned muscle was evaluated. The pressure generating capability of a chamber buried in fibrous adhesions was reduced to approximately 65% of that of a chamber without adhesions. The stroke volume and stroke work of the assist device driven by the developed pneumatic pressure were measured. The maximum stroke work of the circulatory assist was greater than the stroke work of the right ventricle, but less than that of the left ventricle. In respect to stroke volume, the pneumatic chamber could drive the circulatory assist device against not only a pulmonary range of afterload, but also a systemic range of afterload, when high pre load was available. These results indicate that the compressive skeletal muscle pump with conditioned latissimus dorsi muscle generates acceptable hemodynamic work for right ventricular bypass or aortic counterpulsation. In the long-term, the interface between tissue and actuator is the major obstacle to developing a muscle powered assist device.
Animals↗
Longitudinal study of spinal deformity in Duchenne muscular dystrophy.
To investigate the natural course of the spinal deformity in Duchenne muscular dystrophy (DMD) and its clinical relevance, longitudinal series of spinal radiographs and medical records of 46 patients with DMD were reviewed. The natural course of the deformity was classified into three types; type 1 (n = 21), unremittent progression of scoliosis with kyphosis; type 2 (n = 18), transition from kyphosis to lordosis before age 15 years; and type 3 (n = 7), less deformity without prominent longitudinal changes. Age at loss of ambulatory ability was not a predictor of type. Neither was the age at which the Cobb angle was 30 degrees correlated with the rate of subsequent progression. Because the spinal deformity always progresses, we consider spinal surgery justifiable in type 1, when a certain strict indication exists, such as spinal deformity > 30 degrees and age < 15 years in patients with > 35% predicted value of vital capacity. In type 2, operation may be necessary in patients in whom Cobb angle will progress unremittently. There is no surgical indication for patients with type 3.
Adolescent↗
Small cell carcinoma of the endometrium: report of three cases and literature review.
BACKGROUND: Small cell carcinoma of the endometrium is extremely rare. Aim. We reported three cases of this rare tumor and reviewed the literature. CASES: Case 1 was a 54-year-old woman and case 3 was a 58-year-old woman. Both patients presented with vaginal bleeding. Case 2, a 53-year-old woman, had no symptoms and had a vaginal-cervical smear suspicious for malignancy. All patients underwent surgery and their tumors originated in the endometrium. In all three cases, pathological examination revealed small cell carcinoma of endometrium, and immunohistochemical reactivity for one or more neuroendocrine markers was found in all cases. Under electron microscopy in case 2 and case 3, dense core granules in the cytoplasm of tumor cells were found only in case 3. Case 3 was stage IIIA and died of her disease 12 months after surgery. Both cases 1 and 2 were stage IB and alive with no evidence of disease for 28 months and 9 years, respectively. CONCLUSION: Although the prognosis of small cell carcinoma of endometrium is poor, early detection of this disease may contribute to an improved prognosis.
Carcinoma, Small Cell↗
Preliminary toxicity analysis of intraperitoneal carboplatin in combination with intravenous paclitaxel chemotherapy for patients with carcinoma of the ovary, peritoneum, or fallopian tube.
The objective of this study was to provide preliminary toxicity data of multiple-cycle combination chemotherapy with intraperitoneal (IP) carboplatin and intravenous (IV) paclitaxel for further clinical trials. The toxicity data of 42 patients with mullerian carcinoma who underwent IP carboplatin therapy in combination with IV paclitaxel were retrospectively analyzed. Chemotherapy was repeated through the Bard IP port placed at initial surgery using IV paclitaxel at 175 mg/m2 followed by IP carboplatin. The doses of carboplatin were either at area under the curve (AUC) = 5, 6, 6.5, 7, or 7.5. The toxicity data in a total of 237 cycles were analyzed. The median number of cycles for IP chemotherapy was 6 (range: 3-12). The incidences of maximal grade toxicities in all cycles were: grade (G)2/3 nausea/vomiting, 23.8%; G2/3 constipation, 42.9%; G2 abdominal pain, 28.6%; G2/3 sensory neuropathy, 14.3%; motor neuropathy, 4.8%; myalgia/arthralgia 33.4%; G3/4 neutrocytopenia, 85.4%; and G3/4 anemia, 35.4%. These were not related to the dose of carboplatin. The incidences of G3 thrombocytopenia in relation to the dose of carboplatin were AUC = 5, 0%; 6, 31.6%; 6.5, 44.4%; 7, 25.0%; and 7.5, 80%. G4 thrombocytopenia did not occur. A dose of carboplatin between AUC = 6 and 7 with IV paclitaxel at 175 mg/m2 is warranted for further evaluation.
Adult↗
Hormonal function after ovarian transposition to the abdominal subcutaneous fat tissue.
We previously reported a new technique for ovarian transposition to the abdominal subcutaneous fat tissue (OTAFT) following hysterectomy. The purpose of this study is to assess the hormonal function after OTAFT. From 1993 to 2000, OTAFT was performed in 27 patients (group A). Forty-two women underwent hysterectomy and retained ovaries without transposition (group B). In 19 cases, bilateral oophorectomy with hysterectomy was performed, and they received a hormone replacement therapy (HRT) (group C). Serum follicle-stimulating hormone (FSH) level of patients was monitored every 2-12 months, and the time of menopause (defined as FSH >40 mIU/mL two times consecutively) was determined in groups A and B. After a median follow-up of 65 months, cumulative ovarian survival did not show significant difference between group A and group B (HR = 0.52, 95% CI = 0.17-1.16; P= 0.10). In patients who were 40 years old or younger, ovarian function declined significantly in group A compared to group B (HR = 0.29, 95% CI = 0.02-0.91; P= 0.04). However, FSH level of postmenopausal patients in group A was not different from FSH level of patients in group C, but FSH level of postmenopausal patients in group B was significantly higher than FSH level of patients in group C (P= 0.002). Although the procedure of OTAFT may somewhat affect the ovarian function, the transposed ovary in postmenopausal women presumably still secrete a small amount of estrogen which is equivalent to an estrogen level by HRT.
Abdominal Cavity↗
Direct ovarian effect of growth hormone in the rabbit.
PROBLEM: This study was undertaken to assess whether growth hormone (GH) can stimulate follicle growth and ovarian steroidogenesis via putative GH receptors. METHOD: In vitro perfused rabbit ovary. RESULTS: Ovulation occurred in neither the control ovaries nor experimental ovaries treated with 100 ng/ml of GH, whereas all ovaries exposed to 50 IU of human chorionic gonadotropin (hCG) ovulated. The addition of GH to the perfusate significantly stimulated the follicle growth in the absence of gonadotropin. The percent change in follicle diameter in GH-treated ovaries did not differ significantly from that in hCG-treated ovaries. Exposure to GH significantly stimulated the meiotic maturation in the follicular oocytes, as compared with the contralateral control ovaries. Although the concentration of progesterone in the perfusate did not differ significantly between GH-treated and control ovaries, GH stimulated estradiol production by the perfused rabbit ovaries. Rabbit ovary membranes exhibited high affinity binding sites of hGH (Kd = 6.1 x 10(-9) M). CONCLUSION: GH acts on the rabbit ovary to stimulate the follicle growth, oocyte maturation, and ovarian estradiol production by interacting with the specific receptors located in ovarian plasma membranes.
Animals↗
Clinical aspects of 'senile dementia of the tangle type'-- a subset of dementia in the senium separable from late-onset Alzheimer's disease.
There is a subset of dementia patients in the senium, in whom abundant neurofibrillary tangles (NFTs) are present mainly in the hippocampal region without significant numbers of senile plaques. This patient group was thought to be separable from those with Alzheimer's disease based on the results of ApoE allele analysis in addition to the substantial absence of amyloid beta deposits and has been designated as senile dementia of the tangle type (SDT). The clinical pictures of 4 autopsied patients with different amounts of NFTs were examined to characterize the clinical aspects of this type of senile dementia. SDT generally occurs in very old patients and was estimated to account for about 4-6% of patients with dementia in the senium excluding vascular dementia. Clinically, long-lasting memory disturbance is more prominent and personality as well as cognitive functions tend to be preserved. Delirium and other psychotic symptoms are often observed. NFTs and accompanying neuronal loss in the limbic, mainly in the hippocampal, region could be responsible for dementia.
Aged↗
Respiratory factors in the management of patients after open-heart surgery.
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Adolescent↗
Factors affecting A-aDo2 after open-heart surgery.
Intrapulmonary shunt, cardiac output, and O2 consumption as factors contributing to alveolar-arterial O2 tension difference (A-aDo2) were tested in 11 patients after open-heart surgery. A-aDo2 was well correlated with intrapulmonary shunt, as expected, but no correlation was found between cardiac index (CI) and intrapulmonary shunt. When total shunt (venous admixture) was above 11%, there was an inverse correlation between A-aDo2 and CI, and it was observed that CI falling below 2.5 L/min/sq m contributed significantly to the enlargement of A-aDo2. Low Pao2 (less than 65 torr, breathing air) was characterized by larger arterial-mixed venous O2 content difference than high Pao2 (is greater than 65 torr, on room air), indicating that A-aDo2 was influenced by cardiac output relative to metabolic demand. Intrapulmonary shunt played a main role in increasing A-aDo2 after open-heart surgery, and systemic factors, including changes in cardiac output and O2 consumption, also contributed to development of hypoxia.
Adolescent↗