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Biomedical subjects

T Ohta

Publications and source records attributed to T Ohta.

At least 1,477 records · Page 82Linked to original sources

Plasma tetrahydrobiopterin levels in patients with psychiatric disorders.

The plasma total biopterin and tetrahydrobiopterin (BH4) levels of 24 psychiatric patients were measured in the symptomatic phase, under no influence of psychotropic drugs as long as possible, and were compared with those of normal controls. The significant increase in total biopterin levels was observed only in the plasma of the patients with affective disorders or panic disorder in the depressive mood. A significant decrease in BH4 levels was observed only in the plasma of the patients with depression, and an increase in BH4 levels was observed only in the patients with hypomania. The changes of these biopterin levels in plasma could be a disease effect or a phase effect.

Adult↗

Stromal distribution of CA 19-9 as a predictor of lymph node metastases in gallbladder cancer without serosal invasion.

Gallbladder cancer without serosal invasion is often diagnosed during the pathologic examination of a gallbladder removed for presumed benign disease. The role of reoperative procedures in these patients is not well established, making it important to define prognostic factors that predict cancer spread. To determine if the pattern of immunohistochemical staining with a monoclonal antibody against CA 19-9 could predict lymph node spread of cancer, 23 patients with gallbladder cancer without serosal invasion were reviewed. CA 19-9 reaction was present in pathology specimens from all 23 patients. Twelve samples (52.2%) showed CA 19-9 in the stroma adjacent to cancer cells, while the remaining 11 did not show any stromal staining against CA 19-9. Lymph node development was found in only 2 (18.2%) of these 11 patients in the nonstromal staining group and 9 (75%) of the 12 patients in the stromal staining group. As these differences were statistically significant, we conclude that immunohistochemical localization of CA 19-9 in gallbladder cancer may be useful in predicting the presence or absence of lymph node involvement, and in developing a rational approach for a reoperative procedure.

Aged↗

Age- and sex-related differences in lipoproteins containing apoprotein A-I.

We investigated age- and sex-related differences in the structure and composition of two species of lipoproteins that contain apoprotein (apo) A-I (A-I Lp): lipoproteins containing apo A-I and apo A-II (Lp A-I/A-II), and lipoprotein containing apo A-I but no apo A-II (Lp A-I), which were isolated by immunoaffinity chromatography. Sixty normolipidemic volunteers were assigned to one of three groups based on their ages and sexual maturation (Group A, prepubertal; Group B, puberty; and Group C, postpuberty). In A-I Lp, the levels of total cholesterol, cholesteryl ester, phospholipid, and apo A-I were lower in males during puberty and then remained stable. In Lp A-I/A-II, there were no age- or sex-related changes in lipids or in apo A-II. Levels of apo A-I in the females were lower with advance in age, although significant differences were observed only between pre- and postpubertal subjects. In Lp A-I, the levels of total cholesterol, cholesteryl ester, phospholipid, and apo A-I were lower in males during puberty and remained stable thereafter, as in the case of A-I Lp. Therefore, the age- and sex-related differences observed in A-I Lp appear to be primarily due to the differences in Lp A-I. When we take into account the constancy of Lp A-I/A-II levels in all groups, the physiological function of A-I Lp (high density lipoprotein) in each individual may be limited by the Lp A-I levels.

Adolescent↗

Evidence for greater susceptibility of isolated dog cerebral arteries to Ca antagonists than peripheral arteries.

In helically-cut strips of dog cerebral, coronary and mesenteric arteries, contracted with prostaglandin (PG) F2 alpha or K+, the addition of verapamil caused a dose-related relaxation. Verapamil-induced relaxations were greater in cerebral than in the other arteries when contracted with PGF2 alpha, but did not significantly differ in the arteries contracted with K+. Similar results were obtained with diltiazem and nifedipine. The contractile response to PGF2 alpha was attenuated by pretreatment with verapamil, the ateenuation being greater in cerebral than in mesenteric arteries. Nitroglycerin and sodium nitroprusside relaxed cerebral, coronary and mesenteric arteries contracted with PGF2 alpha to a similar extent. It may be concluded that dog cerebral arteries contracted with PGF2 alpha, one of endogenous vasospastic substances, are more susceptible to agents which interfere with the influx of Ca++ across cell membranes than coronary and mesenteric arteries; these agents may thus be of value in the treatment and prophylaxis of cerebral vasopasm.

Animals↗

Mechanisms of relaxant action of nicardipine, a new Ca++-antagonist, on isolated dog cerebral and mesenteric arteries.

In helically-cut strips of cerebral and mesenteric arteries contracted with prostaglandin (PG) F2 alpha, carbocyclic thromboxane A2 (cTxA2) or K+, the addition of nicardipine caused a dose-related relaxation. Nicardipine-induced relaxation was greater in cerebral than in mesenteric arteries when contracted with PGF2 alpha and cTxA2, but did not appreciably differ in the arteries contracted with K+. Cerebral arteries contracted with hemolysate and PGF2 alpha relaxed in response to nicardipine to a similar extent. The contractile response to PGF2 alpha was attenuated by pretreatment with nicardipine, the attenuation being greater in cerebral than in mesenteric arteries. Ca++-induced contractions in cerebral and mesenteric arteries previously exposed to Ca++-free media and depolarized by excess K+ were attenuated by nicardipine to a similar extent. PGF2 alpha-induced contractions of cerebral arteries exposed to Ca++-free media were attenuated by nicardipine, whereas those of mesenteric arteries were unaffected. Attenuations by nicardipine of the Ca++-induced contraction in PGF2 alpha-treated cerebral arteries were greater than those seen in mesenteric arteries. It may be concluded that nicardipine produces a greater relaxation of cerebral arteries than mesenteric arteries, possibly due to a greater inhibition of the Ca++-influx and to a decrease in the release of Ca++ from intracellular storage sites in cerebral arteries. As far as the concentrations used are concerned, nicardipine appears to attenuate the inward movement of Ca++ across cell membrane in mesenteric arterial smooth muscle, but not the release of intracellularly stored Ca++.

Animals↗

Early active motion and weightbearing after cross-stitch achilles tendon repair.

Twenty-two closed Achilles tendon ruptures caused by sports injuries in 22 patients (average age, 37.6 years) were repaired with Kirschmayer core suture and cross-stitch epitenon suture, and early active ankle motion with weightbearing was implemented after surgery. This study was undertaken to evaluate the effectiveness of the repair technique and rehabilitation protocol by assessing clinical results and magnetic resonance imaging findings. The follow-up period averaged 24.6 months. Twenty of the tendons (91%) healed without rerupture, and two tendons (9%) suffered a partial rerupture at 23 and 56 days, respectively. Active ankle extension reached from the minus range to 0 degree in an average of 9.7 days, and ankle motion recovered to normal in an average of 6.0 weeks. Full weightbearing without heel raising became possible in an average of 16.4 days, and heel raising with both legs became possible in an average of 7.3 weeks. The patients returned to full sports activity in 13.1 weeks. The interval until the area of high-intensity signal at the tendon repair site on T2-weighted magnetic resonance imaging scans became intermediate-intensity signal averaged 6.9 weeks, and the tendon repair site became low-intensity signal in an average of 12.6 weeks, demonstrating excellent tendon healing. Treatment employing Kirschmayer core suture and cross-stitch epitenon suture may help athletes return to sports activity in a shorter period than that allowed by previous methods of repair for Achilles tendon ruptures.

Achilles Tendon↗

Elimination of iomeprol in patients undergoing continuous ambulatory peritoneal dialysis.

OBJECTIVE: To examine the elimination of iomeprol, its safety in clinical use, and its peritoneal permeability in continuous ambulatory peritoneal dialysis (CAPD) patients with variable degrees of residual renal function (RRF). DESIGN: A nonrandomized comparison study. SETTING: Hospitalized patients in CAPD unit of Chikuho and University Hospitals. PARTICIPANTS: Fourteen patients treated by CAPD and 6 by hemodialysis (HD). INTERVENTIONS: Total dialysate, blood, and 24-hour urine collections were obtained for 4 consecutive days after the administration of iomeprol. A peritoneal equilibration test was performed just before and after the administration of iomeprol. MEASUREMENTS: Iomeprol (iodine) concentration was measured. Residual renal function was estimated as the mean of renal creatinine and urea clearances. Dialysate-to-plasma ratios (D/P) of creatinine and iomeprol were also determined. RESULTS: In all CAPD patients, plasma iomeprol clearance was markedly slow, with a biological half-life (T1/2) of over 32 hours. However, no patients suffered from any adverse effects, and over 80% of plasma iomeprol was eliminated during the 4-hour HD. The plasma iomeprol elimination rate was significantly higher from 4 hours after the iomeprol administration in CAPD patients with RRF [mean estimated creatinine clearance (CCr) 3.8 mL/min, n = 7] compared to the remaining patients (mean estimated CCr 0.6 mL/min, n = 7); however, T1/2 in patients with RRF was over 24 hours. D/P creatinine was significantly correlated with D/P iomeprol, and peritoneal iomeprol permeability may depend on an individual's peritoneal solute transport properties. CONCLUSIONS: A prolonged elimination rate of iomeprol was documented in our CAPD patients both with and without RRF. A HD procedure or intensive peritoneal dialysis just after the use of iomeprol may be advisable to promptly remove circulating iomeprol.

Contrast Media↗

Prevalence of hepatitis G virus (HGV) infection in an endemic area of hepatitis C virus (HCV) infection.

BACKGROUND/AIMS: We investigated the prevalence of hepatitis G virus infection among inhabitants of a hepatitis C virus endemic area. METHODOLOGY: Two hundred and eighty-eight inhabitants, who underwent medical examinations for health screening, were enrolled in this epidemiological study. HGV RNA and HCV RNA were detected by polymerase chain reaction. We also examined anti-HGV envelope protein (E2) antibodies in all serum samples. RESULTS: In these 288 inhabitants, we found anti-HCV antibodies (HCV-Ab) and HCV RNA in 28.5% and 17.4%, respectively. HGV RNA and anti-HGV E2 were detected in 9 (3.1%) and 16 (5.5%), respectively. One patient was positive for both HGV RNA and anti-HGV E2. The exposure rate, expressed as the percentage of people with HGV RNA and/or anti-HGV E2, was 8.3%, which was significantly lower than the incidence of positive HCV-Ab. Of the 24 patients with HGV RNA and/or anti-HGV E2, 15 (62.5%) were positive for HCV-Ab, of those HCV RNA was detected in 9 (37.5%). Further, we found a higher prevalence of HGV exposure in patients with HCV-Ab than in those without (8.3% vs. 4.4%). CONCLUSIONS: HGV infection was not identical to the epidemic hepatitis C virus infection among inhabitants of this town, suggesting that hepatitis C virus might be less infectious than hepatitis C virus.

Adult↗

Anomalous pancreaticobiliary ductal junction without bile duct dilatation in gallbladder cancer.

BACKGROUND/AIMS: Anomalous pancreaticobiliary junction is a rare anomaly but is a risk factor for primary carcinoma of the gallbladder. To define the relationship between anomalous pancreaticobiliary junction, especially if it is not associated with common bile duct dilatation, and gallbladder carcinoma, we retrospectively reviewed data of 126 patients with gallbladder carcinoma. METHODOLOGY: All these patients had undergone direct cholangiography either by endoscopic retrograde cholangiopancreaticography or percutaneous transhepatic cholangiography. RESULTS: Among 126 patients with gallbladder cancer, 23 patients (18.3%) exhibited anomalous pancreaticobiliary junction. Patients with anomalous pancreaticobiliary junction were younger (mean age: 54 +/- 9.1 years) than patients without anomalous pancreaticobiliary junction (mean age: 65 +/- 9.7 years). The incidence of gallstones in patients with anomalous pancreaticobiliary junction (17%) was significantly lower than in those without this anomaly (64%) (P < 0.01). Among the 23 patients with anomalous pancreaticobiliary junction, 12 patients (52%) had no bile duct dilatation and, 11 patients (48%) had bile duct dilatation in the form of fusiform or cylindrical dilatation. However, no cases with severe cystic dilatation were found. Patients of anomalous pancreaticobiliary junction without common bile duct dilatation had more advanced disease and poor prognosis than those with common bile duct dilatation. CONCLUSIONS: The present study revealed that gallbladder cancer in the patients of anomalous pancreaticobiliary junction without common bile duct dilatation was diagnosed at advanced stage and the prognosis was very poor. Therefore, if a minor abnormality is detected in the wall of acalculous gallbladder on ultrasonography, direct cholangiography should be done to exclude this anomaly.

Adult↗

Tanycytic ependymoma in association with neurofibromatosis type 2.

A rare case of tanycytic ependymoma associated with neurofibromatosis type 2 (NF2) is presented for the first time, with emphasis on its clinical course and histopathological features. A 30-year-old man had developed gait disturbance in his childhood, and harbored multiple tumors in spinal nerve roots, in the intradural extramedullary and intramedullary spinal cord. The spinal root tumor and intradural extramedullary tumor were histologically diagnosed as schwannoma and meningioma, respectively. Magnetic resonance imaging showed two intramedullary cystic lesions, one in the cervical and the other in the thoracic spine. Because his sensorimotor dysfunction in the lower extremities continued to worsen gradually, three of the multiple nodular tumors in the thoracic cystic lesion were removed. All three tumors were composed of eosinophilic piloid cells with modest nuclear pleomorphism. No Rosenthal fibers were found. A concentration of slender eosinophilic cellular processes surrounding the vascular wall was seen. Periodic acid Schiff and Masson trichrome-positive balloons were seen in the extracellular space. Detection of ependymal rosettes, although only few in number, led the diagnosis as a tanycytic ependymoma. Recognition of this ependymoma variant should be emphasized to avoid confusion with pilocytic astrocytoma or intramedullary schwannoma.

Adult↗

Clinical analysis of cancer patients with bacteremia for the past ten years (1982-1991).

A trend in bacteremia associated with malignancies was studied in 159 cancer patients (pts) over the past ten years (1982-1991) in our university hospital. The proportion of female, aged persons and patients from the Int Med Dept had a tendency to increase in the later 5 years compared to the former 5 years. There was no significant change in proportion among G (+), G (-) and fungus groups. However, St. aureus has a tendency to increase among G (+) bacteria and Ps. aeruginosa among G (-) bacteria. The clinical features of the cancer patients with bacteremia were different depending on the types of organisms or kinds of underlying malignancies.

Adult↗

Cerebellar glioblastoma genetically defined as a secondary one.

We report here the case of a 29-year-old woman with cerebellar glioblastma. In the present case, tumor lesions were observed in each cerebellar hemisphere. The left-side lesion was diagnosed as glioblastoma, and the right-side lesion as malignant astrocytoma by histopathology. Immunohistochemistry revealed that the tumor cells of the left-side lesion was positive for p53, whereas epidermal growth factor receptors (EGFR) were negative in tumor cells from both sides. Genetic alterations were investigated using a genome DNA microarray (GenoSensor Array 300), which has led us to define this tumor as a secondary glioblastoma. The clinical presentation and genetic findings of this relatively rare entity are discussed.

Adult↗

Campylobacter fetus infection of abdominal aortic aneurysm.

A 61-year-old man with Campylobacter fetus infection of an abdominal aortic aneurysm treated surgically is presented herein, the fifth survival case reported in the literature. Fever and back pain preceded the enlargement of atherosclerotic abdominal aortic aneurysm. The patient tolerated satisfactorily total excision of the aneurysm followed by axillo-femoral prosthetic bypass. Antibiotic therapy consisted of intravenous infusion of fosfomycin and gentamicin and oral administration of minocycline. The organism cultured from the aneurysmal wall and intraluminal thrombi was identified as Campylobacter fetus from its typical characteristics. It is concluded that this organism should be considered in all cases of infected aneurysm in elderly or debilitated patients.

Aneurysm, Infected↗

Cerebrospinal fluid cytology in patients with brain tumors; a simple method using the cell culture technique.

A simplified cytologic method using the cell culture technique was employed in 71 cases with brain tumor. Neoplasitc cells were demonstrated in 17 cases (24%), that is in 11 out of 30 cases of glioma, four out of ten cases of metastatic brain tumor, and two out of 17 cases of meningioma. None of 14 other miscellaneous tumors proved positive. Identification of glioma cells could be easily made because they usually showed characteristic morphology and good proliferation in vitro. However, for other types of tumor, conventional methods were considered to be superior to the culture method because their exfoliated cells usually underwent rapid degeneration without showing characteristic morphology during the culture. Some of the illustrative cases were presented.

Adolescent↗

Thrombectomy for acute deep vein thrombosis: prevention of postthrombotic syndrome.

Ninety-six limbs of 89 patients with acute deep vein thrombosis of the lower extremity were followed for 1 to 18 years. In the thrombectomy group (43 limbs), the cumulative incidence of pigmentation at the 15th year was 15%, but no stasis ulcers occurred throughout the follow-up period. In the conservative treatment group (53 limbs), the cumulative incidence of pigmentation at the 15th year was 41%, and that of stasis ulceration was 27%. Fogarty thrombectomy restricted below the pelvic vein spur and removal of thrombi in the leg veins by manual milking is sufficient to relieve early morbidity, preserve venous valve function, and promote intrapelvic collateral circulation. Preservation of venous valves in the femoropopliteal region is a key to the prevention of postthrombotic syndrome. Thrombectomy within 5 days of the onset of symptoms is recommended for patients with iliofemoropopliteal venous thrombosis.

Adult↗

CT of follicular adenoma in the thyroid gland.

Computed tomography was performed in 27 lesions of follicular adenoma. About half of them showed heterogeneous low density areas due to retrogressive changes, especially internal hemorrhage. Seven out of 12 lesions whose contours were poorly defined had chronic focal thyroiditis of the adjacent thyroid gland. Internal hemorrhage was another cause of indistinct contour in two lesions. We stress that CT features of follicular adenomas are modified by their retrogressive changes and inflammation of the adjacent gland.

Adenoma↗

Surgical management of intracavitary cardiac tumors. A review of fifteen patients and current status in Japan.

Fifteen patients with intracavitary cardiac tumors were operated on at the Kobe University Hospital between September 1977 and January 1984. Three of the patients were men and twelve were women. They ranged in age from 9 to 75 years. Their symptoms were chest pain, dyspnea, cough, palpitation and syncope. Definite diagnosis was confirmed by echo- and cineangiocardiography. There were 14 benign tumors consisting of 13 myxomas, one leiomyoma and one malignant myxosarcoma. The left atrium was the most common chamber involved (12 instances), followed by the right atrium (3). Surgery was performed in all cases under cardiopulmonary bypass with moderate hypothermia and cold crystalloid cardioplegia. Tumors were removed en bloc at the base with their attachment to the atrial septum or free wall in all cases. Three patients underwent concomitant mitral annuloplasty or mitral commissurotomy. Two cases with left atrial myxoma died postoperatively: one case associated with mitral annuloplasty died of congestive heart failure due to newly developed chordal rupture two months after surgery, and the other died of congestive heart failure 13 months after the first operation. Re-excision for recurrence of the myxosarcoma in the left atrium was performed in the latter case as a second surgical procedure. The remaining 13 cases with benign tumors are doing well and are without recurrence. From these favorable results, surgical intervention should be recommended prior to the occurrence of heart failure and severe complications such as coronary or peripheral embolism whenever cardiac tumors are detected by non-invasive echocardiography and cineangiocardiography.

Adolescent↗