Biomedical subjects

T Ohtsuka

Publications and source records attributed to T Ohtsuka.

At least 199 records · Page 11Linked to original sources

PubMed1995

[Bronchogenic carcinoma associated with right aortic arch and postaortic left brachiocephalic vein--report of a case].

61-year-old male was admitted to our hospital for surgical treatment of bronchogenic squamous cell carcinoma arising from left B8. The patient had right aortic arch with aberrant left subclavian artery and postaortic left brachiocephalic vein. Intraoperatively, left ligamentum arteriorsus forming vascular ring between the left subclavian artery and the pulmonary artery was found, however the ligamentum arteriorsus was not divided because no symptom of esophago-tracheal compression was observed. The left brachiocephalic vein was located between the ascending aorta and the arterial ligament. The lower lobe of the left lung was resected, and lymph nodes in the left side of the mediastinum were dissected easily because the aortic arch was positioned on the other side. Preoperative assessment of the type of branching and the course of arteries and veins is important for safe operation.

Aorta, Thoracic↗

PubMed1995

[New tactile sensor for thoracoscopic detection of intrapulmonary nodules].

We have developed a new tactile sensor which can be used for thoracoscopic detection of invisible intrapulmonary nodules. We applied this new device for consecutive ten cases to excise twelve intrapulmonary nodules thoracoscopically from August 1994 to January 1995. In this report, one of ten cases was presented. The patient was a forty-three-year-old female and admitted with an indeterminate nodule on chest X-ray and computed tomography. When the sensor probe quantifying the hardness of objects by the changes in resonance frequency of the sensor (delta f) passed above the nodule, a sudden jump was evoked in delta f curve on the computer screen. The nodule was resected thoracoscopically and proved pathologically to be adenocarcinoma. Thoracoscopic procedure was then converted to open thoracotomy and lobectomy with lymph node dissection was performed.

Adenocarcinoma↗

PubMed1995

[Solitary rectal carcinoma metastasis to the left hilar lymph nodes: a case report].

A 66-year-old woman was referred to this institution for treatment of hemoptysis, atelectasis of the left upper lobe, and marked hypoxia necessitating oxygen therapy. A low anterior resection of the rectum had been performed for rectal adenocarcinoma 6 years and 3 months before this admission, and was followed by another resection after a local recurrence 20 months later. Bronchoscopy revealed an endobronchial tumor obstructing the left upper lobe bronchus. Tissue from a transbronchial biopsy revealed metastatic rectal carcinoma of the endobronchial lumen. There was no evidence of local recurrence or metastasis to other organs. A left pneumonectomy and lymph node dissection were performed successfully. The postoperative course was uneventful, and the patient was discharged after marked improvement of the arterial blood gas results. The pathological diagnosis of a resected tissue specimen was metastatic adenocarcinoma of the left hilar lymph nodes with invasion of the left main bronchus and protrusion into the endobronchial lumen. The patient remained disease-free for 6 months. At that time, computed tomography of the chest disclosed small metastases in the right lung and chemotherapy was begun.

Adenocarcinoma↗

PubMed1995

Image analysis of nail fold capillaries in patients with Raynaud's phenomenon.

Videograph images of nail fold capillaries in patients with Raynaud's phenomenon were analyzed, and capillary patterns were defined using standardized canonical discriminant analysis. Of sixty-eight patients with Raynaud's phenomenon, forty-nine (72 percent) showed a systemic sclerosis pattern and nineteen (28 percent) showed a normal pattern. The systemic sclerosis type capillary pattern significantly correlated not only with secondary Raynaud's syndrome but also with sclerodactyly, telangiectasia, and antinuclear antibody. This study confirms the value of nail fold capillary microscopy as a noninvasive technique for the examination of the cutaneous microcirculation in vivo. We should continue to evaluate the patients with Raynaud's phenomenon who showed systemic sclerosis pattern abnormality to determine if these patients would show a progression to systemic sclerosis or not.

Adolescent↗

PubMed1994

A case of central diabetes insipidus with spontaneous remission after 8 years of the disease.

A 55-year-old male smoker developed polyuria and polydipsia in November 1983. A water deprivation study revealed a defect in the urine concentrating function, which was corrected by vasopressin. Plasma antidiuretic hormone (ADH) was not increased by smoking. His condition was well controlled by deamino-D-arginine vasopressin. However, since February 1992 he has become completely free from the need for medication to control his urine volume. Re-evaluation studies with water deprivation and smoking revealed dramatic improvements in the urine concentrating function and ADH response. A patient with idiopathic diabetes insipidus with spontaneous remission after 8 years is reported.

Diabetes Insipidus↗

PubMed1994

Statistical definition of nailfold capillary pattern in patients with psoriasis.

BACKGROUND: The microvasculature plays an important role in the pathogenesis of psoriatic skin lesions. Our purpose was to try to define a psoriatic pattern in the nailfold capillary, to clarify the relationship between nailfold capillary microscopic changes and nail involvement and to note the general clinical features of psoriasis. METHODS: Image analysis of nailfold capillaries was performed in 62 patients with psoriasis. The capillary pattern was defined statistically comparing it with that of 51 healthy volunteers. We attempted to differentiate the psoriatic pattern from normal controls with "canonical discriminant analysis." RESULTS: Forty-nine of 62 patients with psoriasis could be differentiated from normal controls by our definition of psoriatic pattern that was significantly correlated with periungual psoriatic plaque, nail pitting, onycholysis, and the extent of the involved area. CONCLUSIONS: Our data suggest that nailfold capillary changes reflect microvascular changes of psoriasis and that the nailfold capillary pattern is a useful tool in evaluating nail involvement and the severity of psoriasis.

Adolescent↗

PubMed1994

Diabetic scleredema and scleroderma-like changes in a patient with maturity onset type diabetes of young people.

A 21-year-old housewife with maturity onset type diabetes of young people developed scleredema diabeticorum, scleroderma-like skin thickness on forearms and dorsum of hands, digital sclerosis and cheiroarthropathy. She had diabetes mellitus since the age of 11 years. Her grandfather on the mother's side, her mother and 3 of 5 her mother's brothers and sisters have diabetes mellitus. Blood glucose was 295 mg/dl. Urinary glucose was 5.3 g/day. Nail fold capillary microscopy revealed a progressive systemic sclerosis pattern. Histologically, hematoxylin and eosin sections from back and forearm skin demonstrated broad collagen bundles separated by widened clear spaces throughout the thickened dermis.

Adult↗

PubMed1994

Statistical definition of nail fold capillary pattern in patients with systemic sclerosis.

Image analysis of videographs of nail fold capillaries was performed in patients with systemic sclerosis (SS), and the capillary patterns were defined by canonical discriminant analysis. Forty-eight of 55 SS patients were significantly differentiated from patients with systemic lupus erythematosus and normal controls. Normal controls and patients with systemic lupus erythematosus showed identical nail fold capillary patterns; in patients with dermatomyositis the pattern was similar to that of SS. The canonical discriminant analysis revealed that only 5 of 55 (9%) SS patients showed a normal capillary pattern. The abnormal capillary pattern in SS patients correlated with microvascular disturbances such as Raynaud's phenomenon, digital pitting scars and low finger temperature. Our results indicate that quantitative analysis of the nail fold capillaries is useful in evaluating the microvascular disturbances in SS patients.

Adult↗

PubMed1994

Thrombotic obstruction of the right coronary artery in a postoperative patient with Bland-White-Garland syndrome.

A 53-year-old female presented with symptoms of severe chest and back pain associated with oliguria. The patient had a history of exertional dyspnea since the age of 20, and easy fatigability since the age of 27. At the age of 41, she noted marked exacerbation of these symptoms after suffering from a cold and was ultimately diagnosed as having Bland-White-Garland (BWG) syndrome with mitral valve regurgitation. The patient then underwent re-implantation of an anomalous left coronary artery from the pulmonary artery to the posterolateral wall of the aorta. Eleven years later, she re-presented with symptoms of angina and congestive heart failure. Coronary angiography was subsequently performed and a total occlusion of the right coronary artery with probable thrombus was revealed. The right coronary artery was filled via collaterals from the implanted left coronary artery. Mitral regurgitation was noted during angiography. The patient underwent aorto-coronary artery bypass grafting of the right coronary artery and concomitant mitral valve replacement. Her postoperative condition remained excellent.

Coronary Angiography↗

PubMed1994

Panclicins, novel pancreatic lipase inhibitors. II. Structural elucidation.

Panclicins A-E are novel and potent pancreatic lipase inhibitors produced by Streptomyces sp. NR 0619. Their structures have been elucidated based on NMR and FAB-MS experiments. The relative configurations have also been determined by NMR experiments. The absolute stereochemistry has been determined by the chiral HPLC analysis of the hydrolysates of panclicins A and B and by modified Mosher's method on a derivative of panclicin A. They are structurally related to beta-lactone esterase inhibitors of microbial origin, lipstatin, valilactone, ebelactones and esterastin. Panclicins also contain a beta-lactone structure with two alkyl chains, one of which has an N-formylalanyloxy or N-formylglycyloxy substituent.

Lactones↗

PubMed1994

Cyclothialidine, a novel DNA gyrase inhibitor. II. Isolation, characterization and structure elucidation.

Cyclothialidine is a novel DNA gyrase inhibitor produced by Streptomyces filipinensis NR 0484. It was isolated from the culture broth by charcoal adsorption, Diaion HP-21, Amberlite CG-50, DEAE Toyopearl, and Toyopearl HW-40 SF column chromatography. The structure of cyclothialidine was determined to be a unique twelve membered lactone by amino acid analysis and various 2D-NMR experiments. Cyclothialidine inhibited Escherichia coli DNA gyrase with an IC50 of 30 ng/ml.

Amino Acid Sequence↗

PubMed1994

Hispidospermidin, a novel phospholipase C inhibitor produced by Chaetosphaeronema hispidulum (Cda) Moesz NR 7127. II. Isolation, characterization and structural elucidation.

Hispidospermidin (1) is a novel phospholipase C inhibitor produced by Chaetosphaeronema hispidulum (Cda) Moesz NR 7127. Its structure (C25H47N3O) has been elucidated as a cage compound with a trimethylspermidine side chain based on various NMR studies, including 1H-1H COSY, 13C-1H COSY, HOHAHA, HMBC, COLOC and long range J C-H resolved 2D spectroscopy. The absolute configuration of 1 has been elucidated by modified Mosher's method on the (R)- and (S)-MTPA amides of a derivative of 1.

Chaetomium↗

PubMed1994

[Thoracoscopic treatment of intrathoracic diseases].

Recently developed thoracoscopic surgical equipment and related instruments have enabled us to perform two groups of advanced thoracoscopic surgical procedures. Group 1: procedures formerly performed by open thoracotomy, and group 2: procedures performed by thoracoscopic surgery only. Group 1 includes bullectomy for spontaneous pneumothorax, wedge resection for lung nodules, resection of benign tumors of the mediastium or chest wall, lung lobectomy, and resection of giant bullae. Because thoracoscopic surgery is minimally invasive, intrathoracic surgical procedures should be performed by thoracoscopic surgery if the results are the same. Group 2 consists of surgery in patients with poor pulmonary reserve and laser ablation of the bullous lung in advanced emphysema. Until recently, surgical intervention was not an option in the patients in groups 2 because of the invasiveness of open thoracotomy. Thoracoscopic surgery allows resection of tumors in early stage lung cancer in patients with poor pulmonary reserve. Severely emphysematous lungs can be ablated with a laser and shrunk, to normalize pulmonary compliance, residual volume and total lung capacity, and thus relieve symptoms.

Humans↗

PubMed1994

[Thoracoscopic resection of schwannoma: a report of two cases].

We have performed thoracoscopic resection of schwannoma without intraspinal extension in two asymptomatic cases confirmed by chest roentgenogram and computed tomography: the case 1 with the tumor as large as 4.0 x 4.0 x 3.5 cm found in the paravertebral fifth Intercostal space, the case 2 with the tumor as large as 3.2 x 2.5 x 1.8 cm found on the first rib in contact with the supreme intercostal vein. In the operation of case 1, the dilated fifth intercostal vein in contact with the tumor which could not be controlled by Endo-Clip was doubly ligated by the use of Knot-Pusher. The tumor was successfully dissected from the chest wall and proved to arise from the fifth intercostal nerve. The tumor was brought into Endo-Pouch and extracted through one of the skin incisions which was minimally enlarged to accommodate the pouched lesion. In the operation of case 2, curved forceps facilitated the procedure because the tumor located near the apex of thorax. The tumor was found to originate from sympathetic nerve and removed through the minimally enlarged incision as case 1. We conclude as the following. The benign tumor found in the mediastinum or the chest wall is amenable to thoracoscopic treatment. In thoracoscopic procedure, as the operation under thoracotomy, we must acquire skills of standard operative technique, i.e., suture or ligation, because those skills are necessary when Endo-Clip or Endo-GIA cannot be used. The skin incision should be minimally enlarged finally when the specimen is extracted to minimize operative intervention.

Adult↗

PubMed1994

[Nontraumatic subdural hematoma secondary to dural metastasis of lung cancer: case report and review of the literature].

In this paper, a case of nontraumatic subdural hematoma secondary to dural metastasis of lung cancer was presented and 43 cases in the literature were reviewed. A 75-year-old man who had been affected with lung tuberculosis for the previous 7 years was admitted to our hospital because of right hemiparesis and aphasia. No history of head injury was discovered. On admission, he was fully conscious and no other neurological abnormalities were noticed except for right hemiparesis and motor aphasia. The chest X-ray revealed abnormal shadows on the right lung, which were most suggestive of tuberculosis. Laboratory studies including prothrombin time, platelet count and fibrinogen were normal. The CT scans taken at that time demonstrated a large subdural hematoma over the left hemisphere. Under a diagnosis of chronic subdural hematoma, emergency evacuation through a small burr hole was performed. However, because of its low liquidity, the hematoma was insufficiently removed. Postoperatively, hemiparesis gradually disappeared. On the 20th hospital day, he suddenly became unconscious and CT scans showed recurrence of the subdural hematoma. Temporo-parietal craniotomy was immediately carried out. The dura was thickened and hyperemic. Although the underlying brain was apparently normal, the exploration performed after removal of the hematoma revealed a soft grayish mass extruding into the subdural space from the dura. The bleeding point was not identified. Both the dura and the abnormal tissue were biopsied for histological examination.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1994

[Cavernoplasty for atypical mycobacteriosis of the lung--case report of two M. avium complex].

Two patients were diagnosed as suffering from localized atypical myocobacteriosis of the lung consisting of the infection in tuberculous open healing cavity of left upper lobe and giant bulla of right middle lobe. The type of bacteria classified according to Runyon's criteria was Group 3 (M. avium complex). The bacilli had the resistance to most antituberculotics. One of them had the history of pulmonary tuberculosis complicated with giant cavity in left upper lobe and extensive hard pleural adhesion associated with restrictive ventilatory impairment. Another one had the history or right upper lobe lobectomy for tuberculosis complicated extensive pleural adhesion. A combination of thoracoplasty and cavernoplasty was applied to these two cases whose operation were once to the former and twice to the latter respectively, with satisfactory results. The patients show complete closure of the cavity and bulla and have no symptoms of recurrence after surgery. The application of thoracoplasty and cavernoplasty is useful and safe to the treatment of patients suffering from atypical mycobacteriosis of the lung in cases of prospected tough resection, with expecting one stage cure.

Aged↗

PubMed1993

A somatic cell mutant defective in phosphatidylglycerophosphate synthase, with impaired phosphatidylglycerol and cardiolipin biosynthesis.

Phosphatidylglycerophosphate (PGP) synthase catalyzes a reaction involved in the synthesis of phosphatidylglycerol (PG), which serves as a metabolic precursor for cardiolipin (CL), found primarily in the mitochondrial membranes of eukaryotic cells. We isolated a Chinese hamster ovary cell mutant (designated PGS-S) with a specific lesion in PGP synthase by using an in situ enzymatic assay for the enzyme. This mutant was obtained by introducing a second mutation into mutant PGS-P that had been generated by first-step mutagenesis. The PGP synthase activities in cell extracts of mutant PGS-S grown at 33 and 40 degrees C were 14 and 1% of those in the wild type cells, respectively; in addition, PGP synthase in cell extracts of mutant PGS-S exhibited higher sensitivity to heat than that of the wild type. Mutant PGS-S also showed a temperature-dependent defect in the synthesis of PG and CL in vivo, together with temperature sensitivity for cell growth. A temperature-resistant revertant of mutant PGS-S simultaneously restored PGP synthase activity and the ability to synthesize PG and CL in vivo to nearly the same levels as those of mutant PGS-P. These results constitute genetic evidence that PGP synthase is responsible for PG synthesis and is essential for cell growth.

Animals↗

PubMed1993

Mitochondrial dysfunction of a cultured Chinese hamster ovary cell mutant deficient in cardiolipin.

In our preceding paper, we reported that a temperature-sensitive Chinese hamster ovary cell mutant, PGS-S, with thermolabile phosphatidylglycerophosphate synthase was defective in the biogenesis of both phosphatidylglycerol and cardiolipin (CL) at a nonpermissive temperature (Ohtsuka, T., Nishijima, M., and Akamatsu, Y. (1993) J. Biol. Chem. 268, 22908-22913). To investigate the biological role of cardiolipin, we examined the structure and function of mitochondria in mutant PGS-S cells, since CL is primarily found in the mitochondrial membranes of eukaryotic cells. Under conditions where the formation of CL was impaired, this mutant had both morphological and functional mitochondrial abnormalities, manifested by more stringent temperature sensitivity for cell growth in glucose-deficient medium and by reduced ATP production, increased glycolysis, and reduced oxygen consumption in intact cells. Rotenone-sensitive NADH oxidase activity in cell extracts was also reduced in the mutant cultivated at a nonpermissive temperature, showing a defect(s) in the respiratory electron transport chain of mitochondria. Of the respiratory chain complexes, rotenone-sensitive NADH-ubiquinone reductase (Complex I) was most severely impaired in the mutant, whereas its activity was restored in a revertant of the mutant that had regained the ability to synthesize CL. These results suggest that CL plays a critical role in mitochondrial functions, at least in the respiratory electron transport chain.

Adenosine Triphosphate↗