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Biomedical subjects

T Oka

Publications and source records attributed to T Oka.

At least 955 records · Page 53Linked to original sources
PubMed1989

[Hydronephrosis caused by Crohn's disease: a case report--review of 41 cases with urinary tract complication reported in Japan].

A 34 year-old man, who had been under care with diagnosis of Crohn's disease in the department of gastroenterology of our hospital since 1983, was referred to our urological clinic on May 21, 1987, because of right hydronephrosis found on ultrasonography. He did not complain of any urological symptoms. He underwent further roentgenographic examinations and a diagnosis of hydronephrosis complicated with Crohn's disease was made. On surgery of July 30, resection of ileocecal lesion, end-to-end ileocolostomy, right ureterolysis were performed. He is now visiting our clinic without recurrence of hydronephrosis up to present (7 months). In addition, we reviewed the 41 cases of urological disorders complicated with Crohn's disease in the literature reported in Japan. The cases were of vesicoenteric fistula including pericystitis (33 cases), hydronephrosis (10 cases), urolithiasis (2 cases) and ureterocolonic fistula (1 case). The patients were from 10 to 57 years (27.2 years in average) old. Sex distribution was uneven, 39 of patients were men and 2 were women. Urologic surgery was performed in almost all of the cases except for the patient with urolithiasis. All the patients having vesicoenteric fistula had urological complaints but the patients with hydronephrosis were relatively free from urological complaints. Thus, Crohn's disease has been recognized as an important gastrointestinal disease for urologists, and we will emphasize that periodical abdominal ultrasonography and urography for the patients with this disease should be necessary for checking up other complications such as hydronephrosis.

Adult↗
PubMed1989

[A case of adrenal myelolipoma].

A case of adrenal myelolipoma is presented. The patient was a 61-year-old woman who complained of lumbago this time. A tumor of the left adrenal gland, however, had been found by computed tomography 4 years earlier. Judging from the CT, the size of this tumor had not changed at all, although the density of the mass on admission had reduced, compared with that of 4 years earlier. Laboratory examinations of adrenal function was normal. Left adrenalectomy was performed. Histologically, this tumor consisted of adipose and some hematopoietic tissue. We reviewed 43 cases of adrenal myelolipoma resected surgically in Japan.

Adrenal Gland Neoplasms↗
PubMed1989

[Mixed gonadal dysgenesis with plasty in males].

A 13-year-old Korean boy is reported here as a case of mixed gonadal dysgenesis. The patient presented with perineal hypospadia. He had scrotal testis, epididymis, vas deferens on right side, and abdominal streak gonad, Fallopian tube on left side. He had also uterus and vagina. His chromosome was 46XY type. Among 59 reported cases in Japan, 12 had undergone plasty into male. All of them had hypospadia. In 51 cases, 17 had testes in scrotum. None of them had a testicular tumor. So we decided to do plasty in male, and to follow up his testis quite carefully.

Adolescent↗
PubMed1989

[A case report of successful treatment using ECMO in severe status asthmaticus during open heart surgery].

A 6-year-old boy who had a history of asthma attack since 3 years old, but whose symptom was well controlled with medication received a radical operation for ASD. During the operation, he suffered from severe asthma attack. In blood gas analysis, PCO2 was increased to 302 mmHg with a decrease of pH to 6.740. Every conventional treatment for asthma attack was not effective, and then extracorporeal membrane oxygenation (ECMO was performed within 2 hours after operation. Blood gas data normalized and his hemodynamic condition was well maintained by ECMO. After 4 hours 20 minutes, he was weaned off from ECMO. Post operative course was uneventful except for pneumothorax.

Asthma↗
PubMed1989

[Successful surgical treatment of total left anomalous pulmonary venous return with intact atrial septum--a case report].

A successful repair of total left anomalous pulmonary venous return with intact atrial septum is reported. A 7-year-old girl was admitted for evaluation of cardiac murmur which was first noted at 3 months of age. She had been followed up on suspicion of ASD, without any subjective symptoms. Physical examination on admission revealed a systolic ejection murmur at left sternal border. Chest X-ray showed mild cardiomegaly and increased pulmonary vascularity. ECG showed right axis deviation and incomplete right bundle branch block. Selective pulmonary arteriography delineated anomalous return of all left pulmonary veins to RA via vertical vein, left brachiocephalic vein, and SVC, and documented the absence of an atrial septal defect. Ratio of pulmonary to systemic blood flow was 2.2. Vertical vein was anastomosed to left atrial appendage under cardiopulmonary bypass. Postoperative cardiac catheterization showed no difference of wedge pressure between bilateral PA. The patient is up and well 1 years and 6 months after operation.

Child↗
PubMed1989

[Postoperative thromboembolism of acquired mitral valve disease--comparison between valve replacement and commissurotomy].

Thromboembolism after mitral commissurotomy (MC) was compared with that after mitral valve replacement (MVR). In 216 surgical cases of acquired mitral valve diseases, including combined operative cases of other valves, thromboembolic complications after MC were observed in 9/137 cases (13 times, 0.94%/patient-year), and those after MVR in 8/70 cases (11 times, 2.55%/patient-year). No thromboembolism occurred in 9 cases of annuloplasty. Thromboembolism-free period after MVR (49 +/- 44 months) was significantly shorter than that after MC (102 +/- 43 months, p less than 0.05). Postoperative CTR of thromboembolic cases (69.5 +/- 8.2%) was significantly larger than that of non-thromboembolic cases (61.4 +/- 9.9%) in MVR group (p less than 0.005), but no significant difference existed between thromboembolic and non-thromboembolic cases in MC group. Thromboembolism after MVR occurred in severe cases, but that after MC often occurred in mild cases. Postoperative echocardiogram of MC group showed significantly lower DDR in thromboembolic cases (1.9 +/- 0.7 cm/sec) than in non-thromboembolic cases (3.2 +/- 1.2 cm/sec, p less than 0.025). Mitral valve area (MVA) of all re-stenotic cases in thromboembolic cases after MC was under 1.5 cm2, comparing that in non-thromboembolic cases there were only two cases that had MVA under 1.5 cm2. After MC, careful management including anticoagulant therapy and reoperation is necessary especially in patients with atrial fibrillation, DDR under 2 cm/sec, and MVA under 1.5 cm2, even though they don't have cardiomegaly.

Adult↗
PubMed1989

[The supracardiac type of total anomalous pulmonary venous return in a ten-day-old neonate: report of a successfully treated case].

A case of a ten-day-old neonate weighing 3,867 g with the supracardiac type of total anomalous pulmonary venous return (TAPVR) is reported. The preoperative diagnosis was determined mainly by digital subtraction angiography. Surgical correction was carried out in this patient as an emergency operation. Under cardiopulmonary bypass on beating which required 3 hours and 7 minutes, anastomosis between the common pulmonary vein and the left atrium, ligation of both the anomalous vertical vein and the persistent ductus arteriosus, and closure of the atrial septal defects were successfully performed. Postoperatively cardiac failure was markedly improved, although 5 days were required for the weaning from the artificial respirator. The angiographic and hemodynamic examinations showed a complete repair of TAPVR. At present, 2 months after the operation, the patient shows an average development.

Female↗
PubMed1989

Immunochemical characterization of the suppressor factor from early human decidual cells.

An immunosuppressive factor was obtained from culture supernatants of early human decidual cells. The suppressor factor was concentrated by gel filtration in a fraction with a molecular weight between 43,000 and 67,000 daltons. It was further purified by biochemical methods. Four peaks were obtained in the fraction with molecular weight between 43,000 and 67,000 daltons by anion exchange chromatography. Only the second peak had immunosuppressive activity in MLR. Lentil-lectin affinity chromatography of this suppressor factor showed that the suppressor factor had no affinity for lentil-lectin sepharose. Isoelectric focusing of the suppressor factor demonstrated four bands. The protein isoelectric (PI) point was approximately 7.50 in one band and between 6.85 and 7.35 in the other three bands. These results demonstrate that the suppressor factor is not glycoprotein but protein, whose PI is between 6.85 and 7.50. The suppressive effect of this purified factor on lymphokine production and lymphocyte activation was investigated. The addition of the purified suppressor factor to a culture of PBL stimulated with PHA suppressed not only IL-2 production and gamma-INF production, but also BSF-2 production. IL-2 receptor expression and transferrin receptor expression of PBL stimulated with PHA were also suppressed by addition of the suppressor factor. These results demonstrate that this suppressor factor inhibits lymphokine production and lymphocyte activation.

Biological Assay↗
PubMed1989

[Heart failure due to rapid right ventricular volume overload in patients with pulmonary hypertension].

We have described three cases of pulmonary artery hypertension (PAH). Two of them developed severe systemic hypotension and cardiac arrest following cardiopulmonary bypass (CPB). Imminent pre-operative right ventricular (RV) failure and subsequent myocardial injury during CPB may have contributed to the insult following CPB. In these cases, RV failure is presumably due to rapid volume overloading, since left atrial pressure (LAP) was essentially unchanged while right atrial pressure (RAP) was markedly elevated during the period of severe hypotension. Furthermore, these events may be attributed to protamine, since the circulatory derangement coincides with its administration. Thus, in these patients with severe PAH, blood transfusion should be carefully titrated under the strict evaluation of both LAP and RAP. Additionally, protamine should be infused at a rate slow enough to avoid concomitant hemodynamic changes. We have also reported a case of over-systemic PAH who was successfully managed intraoperatively by careful monitoring and discreet administration of protamine.

Adult↗
PubMed1989

[A study on bacteria within stones in urolithiasis].

The bacteria in 37 stones obtained from 37 patients with urinary stone diseases, that is, 11 renal stones (containing 2 staghorn calculi), 21 ureteral stones, 4 bladder stones and 1 urethral stone, were studied, according to the Nemoy & Stamey's method. The stones were collected by partial nephrectomy (1 case), nephrolithotomy (1 case), pyelolithotomy (1 case), percutaneous nephrolithotripsy (PNL) (6 cases), 12 ureterolithotomies, transurethral ureterolithotripsy (2 cases), cystolithotripsies (4 cases) and spontaneous deliveries (10 cases). According to a stone analysis by infrared spectrophotometer revealed 30 were noninfection stones (81.1%) and 7 infection stones (18.9%). Of these 37 stones, 5 stones (13.5% of 11 stones) had bacteria within them. These stones consisted of 4 infection stones (57.1% of all infection stones) and 1 noninfection stone (3.3% of all noninfection stones). Out of 4 patients having bacteria within their stones, urine culture of whom were carried out before stones were collected, only one patient (25%) had the same species of bacterium (E. coli) both within the stone and in urine. The E. coli within the stone and that in urine, however, showed quite different reactions to some antibiotics. The fact that all organisms within stones cannot be detected by urine culture before collecting stones of the patients in our present study, suggests that patients undergoing endourological surgery, such as extracorporeal shock wave lithotripsy and PNL, may have a risk of complications, such as severe urinary tract infection and urosepsis, if the possibility of the presence of organisms within stones is not taken into consideration.

Adult↗
PubMed1988

In vivo effects of beta-lactam antibiotics and heterocyclic thiol compounds on vitamin K-dependent carboxylation activity and blood coagulation factors in vitamin K-deficient rats.

The in vivo effects of heterocyclic thiol compounds, corresponding to the 3'-position substituents of several beta-lactam antibiotics, on blood coagulation factors and on liver microsomal gamma-glutamylcarboxylation (gamma-carboxylation) activity were evaluated in rats maintained on a vitamin K-deficient diet. These rats, when compared to normal control animals, exhibited hypoprothrombinemic changes: prolongation of both prothrombin time and activated partial thromboplastin time, decreases in factor VII and plasma prothrombin, and increases in PIVKA II (descarboxyprothrombin) both in plasma and liver. They also displayed a marked increase in liver microsomal gamma-carboxylation activity. These blood coagulation variables could be altered markedly by administering various heterocyclic thiol compounds to the vitamin K-deficient rats, although these compounds did not inhibit gamma-carboxylation activity in an assay system using phylloquinone. A similar pattern of alteration was observed when some beta-lactam antibiotics were administered. Increased microsomal gamma-carboxylation activity in antibiotic-treated vitamin K-deficient rats was normalized by the administration of vitamin K, concomitant with the recovery of blood coagulation variables to the normal range. The results indicate that antibiotic-induced hypoprothrombinemia in vivo is not caused by inhibition of enzymes of the gamma-carboxylation system, such as vitamin K reductase and gamma-glutamylcarboxylase, but is related to the endogenous vitamin K level.

Animals↗