Biomedical subjects

T Okuda

Publications and source records attributed to T Okuda.

At least 217 records · Page 12Linked to original sources

PubMed1994

[Treatment for peritoneal dissemination of gastric cancer by intraperitoneal administration of CDDP through Infuse-a-Port].

This report describes the effect of intraperitoneal administration of CDDP for the treatment of peritoneal dissemination (P) in 20 patients with gastric cancer. Eight patients after palliative resection, 4 after non-resection and 8 with recurrent cancer were given 25 mg of CDDP through a reservoir (Infuse-A-Port) implanted in the abdominal wall once a week. Simultaneously, 400 mg/body/day of UFT and 2 mg/body/week of Lentinan were administered. Twelve of the patients died of disease at 6-19 months (median 7 months), but 8 have survived 3 to 15 months (median 6 months). Complete and partial responses were obtained in 7 of the 8 patients with recurrence (88%) for malignant ascites. No patient showed any toxicity from treatment. All patients receive the treatment in the outpatient clinic after discharge, and 17 patients have shown a long hospital-free survival.

Administration, Oral↗

PubMed1994

[Anaphylactic shock by ophthalmic wash solution containing chlorhexidine].

A 58 year-old male patient developed anaphylactic shock, possibly due to the use of chlorhexidine as ophthalmic wash solution. He was successfully resuscitated without any sequelae. The patient had increased levels of both histamine and tryptase. The skin test for allergy resulted in strong positive to chlorhexidine. There have been many reports regarding severe adverse reactions associated with use of chlorhexidine. It is necessary to pay attention to anaphylactic shock due to chlorhexidine.

Anaphylaxis↗

PubMed1994

[Preoperative sedation for childhood moyamoya disease--clinical evaluation of rectally administered midazolam].

We evaluated the effectiveness of rectally administered midazolam for preoperative sedation in 26 cases of childhood moyamoya disease. The patients, aged 5.0 +/- 1.8 yr (mean +/- SD), received 1 mg.kg-1 of midazolam 30 min prior to induction of anesthesia. The patient's level of sedation, tolerance of anesthesia face mask, and amnesia were evaluated. In 22 of 26 patients induction via face mask was performed smoothly, and excellent anterograde amnesia was observed. Remarkable complications, including hemodynamic and/or respiratory depression, were not noted. The level of sedation was significantly related to the patient's age. Although further investigation to evaluate proper dose are needed, 1 mg.kg-1 of rectally administered midazolam is useful for childhood moyamoya disease, in which crying can worsen the neurological symptoms.

Administration, Rectal↗

PubMed1994

[CT findings of pulmonary sarcoidosis].

A retrospective review was performed on CT findings in 46 patients of pulmonary sarcoidosis proven by histology. Pulmonary lesions were detected in 26 patients (56.5%). Frequent CT findings were peribronchial markings (69.2%), diffuse small nodules (65.4%), pleural lesions (38.5%), lymphangitis carcinomatosa like changes (30.8%), and large irregular nodules (30.8%). Follow up CTs were obtained in 18 patients. Peribronchial markings and diffuse small nodules had tendency to improve, although atelectasis, pleural thickening, and bullae were irreversible and progressive. CT plays an important role in the diagnosis and have a prognostic value in pulmonary sarcoidosis.

Adult↗

PubMed1994

[Subacute necrotizing lymphadenitis with a clinical course mimicking virus-associated hemophagocytic syndrome].

A 17-year old female was admitted to our hospital with fever and systemic lymph node swelling. Laboratory data revealed pancytopenia, elevation of serum lactic acid dehydrogenase, triglyceride and ferritin levels. Bone marrow aspiration showed increased numbers of mature hemophagocytic histiocytes. We suspected virus-associated hemophagocytic syndrome (VAHS) but a biopsied lymph node revealed necrosis without the presence of hemophagocytosis by histiocytes and the diagnosis of subacute necrotizing lymphadenitis (SNL) was made. She recovered entirely after treatment with gamma-globulin, acyclovir and methylprednisolone. This patient was the second reported case of SNL with the clinical course mimicking VAHS and it is necessary to consider the relationship between these two disorders.

Adolescent↗

PubMed1994

[Evaluation of selective lumbar radiculography and radicular block].

We analyzed 56 patients who received selective lumbar radiculography and radicular block (88 procedures in total). The underlying conditions were spinal diseases in 43 cases, cancer pain in 6 cases, post-herpetic neuralgia (PHN) in 5 cases and reflex sympathetic dystrophy (RSD) in 2 cases. In the spinal disease group, 24 cases showed complete pain relief and 12 cases showed partial pain relief after the therapy, with a success rate of 83.7%. In the cancer pain group, 3 cases showed complete pain relief and one showed partial pain relief (success rate: 66.7%). In the PHN group, 1 case showed complete pain relief and 2 showed partial pain relief (success rate: 60%). In the RSD group, all cases showed pain relief. When examined 3 months after this treatment, the effect had persisted in 15 cases from the spinal disease group, in 1 case from the cancer pain group, in 2 cases from the PHN group and in 2 cases from the RSD group. Selective lumbar radiculography and radicular block are useful in identifying a nerve root responsible for abnormalities. In addition, this procedure is expected to exert a long-lasting therapeutic effect in cases indicated for the procedure.

Adult↗

PubMed1994

[Effects of different positions for epidural block on skin-epidural space distance].

Epidural block was performed in the same intervertebral space by both approaches with either flank position or prone position under fluoroscopy. The distances from with both positions the skin to the epidural space (SED) were compared. The prone position approach under fluoroscopy resulted in a significantly greater SED in both T2/3 puncture and L4/5 puncture groups. This was assumed to be due to the fact that the prone position approach does not always allow minimum distance. It was also thought to be due to the fact that in this position, compared with the flank position, a pillow is inserted under the thoracic (or abdominal) region, and the skin in the dorsal region is looser and the subcutaneous tissue is thicker. The lumbar vertebrae form the lordosis, and it does not disappear when the pillow is placed under the abdominal region. This causes the SED to be greater.

Adult↗

PubMed1994

[The effects of prostaglandin E1 infusion during cardiopulmonary bypass on cardiac and renal function in the early postoperative period].

Postoperative complications after cardiac surgery are mainly caused by the detrimental effects of cardiopulmonary bypass (CPB) on hemodynamics and humoral factors. We studied the effects of prostaglandin E1 (PGE1) infusion on CPB induced organ failure. Twenty-four patients who underwent coronary bypass surgery with normal preoperative cardiac and renal function were divided into two groups. PG group (n = 11) was given PGE1 (0.03-0.05 microgram/kg/min) during CPB while the control group (n = 13) was not. Hemodynamic studies with the Swan-Ganz catheter and renal function tests including serum creatinine (Cr), serum beta 2-microglobulin (s-BMG) and urine beta 2-microglobulin (u-BMG) measurements were performed 24 hours after surgery. After CPB, alpha-adrenergic agent requirement was higher in the PG group than in the control group. In the PG group, the mean cardiac index was slightly higher and the mean left ventricular stroke work index was lower than in the control group. Although the mean systemic vascular resistance index was lower in the PG group, the mean pulmonary vascular resistance index was higher because of the vasoconstrictive action of alpha-adrenergic agents. These differences were seen only immediately after surgery; hemodynamic parameters in both groups were at the same level 3 hour postoperatively. Immediately after surgery, creatinine in the PG group was significantly lower than in the control group. While there was no significant differences in s-BMG between the two groups, u-BMG at 6 and 12 hours postoperatively in the PG group were significantly lower than in the control group.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

PubMed1994

[A histochemical study on the acidic glycoconjugates of the synovial membrane in rheumatoid arthritis].

The localization and the nature of glycosaminoglycans (GAGs) in the synovial membrane in 30 patients with rheumatoid arthritis (RA) involving 40 knees were studied by newly developed histochemical methods. To detect the acidic glycoconjugates, sensitized diamine procedures were employed based upon high and low iron diamine stainings. To identify the various molecular species of the GAGs, enzyme (chondroitinase ABC and B, testicular hyaluronidase and keratanase) digestion and chemical modification (nitrous acid treatment) procedures were performed prior to the diamine stainings. The sensitized diamine methods could clearly stain the acidic glycoconjugates contained in the synovial tissue components in shades of brown to black, and could detect the precise distribution patterns of the GAGs. The results obtained in the present study confirmed that the tissue in RA synovial membranes contained various amounts of each GAG molecular species such as dermatan sulfate, chondroitin sulfate A/C, hyaluronic acid and heparan sulfate. Furthermore, the distribution patterns of dermatan and chondroitin sulfates in the diseased synovial tissues were pathophysiologically interesting; in the inflammatory areas, the molecular species of GAGs was primarily dermatan sulfate, whereas in the fibrotic areas, it was mainly chondroitin sulfate A/C. Such results appear to be useful for pathophysiological studies on the synovial tissues of RA.

Adult↗

PubMed1994

[Minimum required number of anesthetists for general hospitals (41-1300 beds) in Japan--analysis of questionnaire, 1992].

BACKGROUND: We have elucidated the deficit of anesthetists in general hospitals excluding university hospitals by assessing the results of questionnaires from 204 institutions in Japan. METHODS: Answers to the questionnaire were computed in average, maximum, and minimum values, using MS-Excel soft ware for statistical analysis. RESULTS: The 204 hospitals were classified into 4 groups; G-1(46)-more than 640 beds, G-2(53)-more than 500 beds, G-3(53)-more than 360 beds, and G-4(52)-less than 359 beds, respectively (parenthesis indicate hospital numbers). The number of cases of anesthesia performed by anesthesiologists were 2055(G-1), 1516(G-2), 1177(G-3) and 959(G-4), respectively. The number of anesthetists per operating table were as follows; 0.62(G-1), 0.62(G-2), 0.58(G-3) and 0.74(G-4), but remarkably low compared to the number of operating theater nurses: 5.49(G-1), 2.96(G-2), 2.82(G-3) and 3.07(G-4). Moreover, the number of emergency cases were as follows; 235(G-1), 187(G-2), 134(G-3) and 125(G-4), respectively. In prolonged surgery over 6 hours, patients were anesthetized with an exchange system or two anesthetists system in 74% of the institutions in G-1. Also, 28-50% of anesthetists in the 4 groups were concerned with intensive care medicine and 0.94-1.54 anesthetists worked in pain clinics with combined operation-theater tasks 1.37-2.49 days per week. In G-1-G-4 institutions, we found that anesthesia cases per year were equivalent to 5 times their bed numbers. CONCLUSION: We concluded that the number of anesthetists should be at least 50% of that of operation-theater nurses. Without increasing anesthesiologists, we cannot expect sophisticated medical care in the 21st century.

Anesthesiology↗

PubMed1993

Novel inhibitors of poly(ADP-ribose) glycohydrolase.

The inhibitory effects on poly(ADP-ribose) glycohydrolase purified from human placenta of three classes of chemically defined tannins; gallotannins, ellagitannins and condensed tannins, were examined in vitro. Oligomeric ellagitannins were found to be most potent inhibitors of poly(ADP-ribose) glycohydrolase, their potencies increasing with increasing number of monomeric residues (dimer < trimer < tetramer). Monomeric ellagitannins and gallotannins were less inhibitory. Condensed tannins, which consist of an epicatechin gallate oligomer without a glucose core, were not appreciably inhibitory. A structure-activity study showed that higher-order conformations of the conjugates with glucose of hexahydroxydiphenoyl and valoneoyl groups, which are unique components of ellagitannins, cooperatively potentiated the inhibitory activity.

Enzyme Inhibitors↗

PubMed1993

Distinct mechanisms of action of V1 antagonists OPC-21268 and [d(CH2)5Tyr(Me)AVP] in mesangial cells.

The effects of two arginine vasopressin (AVP) V1 receptor antagonists, a peptide analogue [d(CH2)5Tyr(Me)AVP] and an orally active non-peptide OPC-21268, on AVP-stimulated Ca transients and 3H-AVP binding were examined in cultured rat mesangial cells. Although both [d(CH2)5Tyr(Me)AVP] and OPC-21268 dose-dependently inhibited AVP-stimulated Ca transients and 3H-AVP binding, their effects were quite different. Magnitude of inhibition of Ca transients by OPC-21268 was comparable when OPC-21268 was added together with or 5 min prior to AVP. However, the inhibition by [d(CH2)5Tyr(Me)AVP] was greater when it was added prior to AVP than when it was added together with AVP. Moreover, washing mesangial cells after OPC-21268 treatment, but not after [d(CH2)5Tyr(Me)AVP] treatment, completely restored AVP-stimulated Ca transients to the control level without antagonists. These results indicate that the cellular mechanisms for two V1 receptor antagonists are different: while the effect of OPC-21268 as a vasopressin antagonist appears to be competitive and reversible, the effect of the peptide antagonist [d(CH2)5Tyr(Me)AVP] seems to be rather irreversible in nature.

Animals↗

PubMed1993

Sensitive high-performance liquid chromatographic determination of 2,2'-[(2-aminoethyl)imino]diethanol bis(butylcarbamate) and its metabolites in human serum following pre-column derivatization with o-phthalaldehyde and stabilization of the derivatives.

A high-performance liquid chromatographic method for the sensitive determination of 2,2'-[(2-aminoethyl)imino]diethanol bis(butylcarbamate) (I) and its metabolites in human serum has been developed. The method was based on a pre-column derivatization with o-phthalaldehyde. The derivatives were stabilized at least for 24 h at 4 degrees C by using N-acetyl-L-cysteine as a thiol and by eliminating the excess o-phthalaldehyde in the reaction mixture by solvent extraction and the addition of an ammonium salt after the reaction. The recoveries and reproducibilities in human serum spiked with I and its two metabolites were satisfactory, and the responses were linear over a wide range of analyte concentrations. The detection limits of I and its metabolites, II and III, in serum were 0.5, 4 and 2 ng/ml, respectively, at a signal-to-noise ratio of 5. The method was satisfactorily applied to the clinical study of I.

3-Mercaptopropionic Acid↗

PubMed1993

Sequential changes in the cell mediators of peritoneal and wound fluids after surgery.

The concentrations of cell mediators in the peritoneal and wound fluids of patients who underwent abdominal surgery or mastectomy were determined sequentially and compared with the concomitant changes in blood components. The level of interleukin-6 (IL-6) in the peritoneal and wound fluids was significantly higher than the plasma level after gastrectomy (P < 0.001), cholecystectomy (P < 0.05), and mastectomy (P < 0.05), although the level of plasma IL-6 was also higher postoperatively than before surgery (P < 0.001, P < 0.05). Significantly higher levels of tumor necrosis factor-alpha were detected in the peritoneal and wound fluids (P < 0.01, P < 0.05, respectively) after surgery despite its absence in plasma. A platelet-specific protein and a protein specific for fibroblasts were also measured. Thus, mediators derived from various cells were shown to be present in human peritoneal and wound fluids, indicating that the local production of these mediators plays an important role in the process of tissue repair.

Adult↗

PubMed1993

Cortical blood flow response to hypercapnia during anaesthesia in Moyamoya disease.

Cortical blood flow (CoBF) was measured continuously by the laser-Doppler method to evaluate the effect of hypercapnia on cortical blood flow during ten surgical procedures in ten young patients (mean +/- SD 9.3 +/- 6.4 yr) with Moyamoya disease. The CoBF was 42.8 +/- 13.4 (ml.100 g-1.min-1) during normocapnia (PaCO2 = 39.0 +/- 2.4 mmHg), and 38.7 +/- 14.4 during hypercapnia (PaCO2 = 47.1 +/- 2.5 mmHg). There was a decrease in CoBF with hypercapnia (P < 0.05) so that the normal CoBF response to hypercapnia was impaired during surgery in the patients with Moyamoya disease. He concluded that patients with Moyamoya disease have a precarious cerebral circulation and hypercapnia may be detrimental to the cortical circulation. This suggests that normocapnia is preferable to hypercapnia in patients with Moyamoya disease during anaesthesia.

Adolescent↗

PubMed1993

Naloxone and flumazenil fail to antagonize the isoflurane-induced suppression of dorsal horn neurons in cats.

Effects of naloxone and flumazenil on isoflurane activities were examined on dorsal horn neurons in cats. Isoflurane suppressed bradykinin-induced nociceptive responses in transected feline spinal cords. The bradykinin-induced neuronal firing rates were significantly suppressed by 60.0%, 35.3% and 32.2% at 10, 20 and 30 min after isoflurane administration, respectively. The 32.3% suppression on bradykinin-induced neuronal responses at 30 min after isoflurane administration was not reversed 5 min after administration of naloxone (36.4% suppression). The suppressive effects of isoflurane were not reversed by naloxone (0.2 mg.kg(-1), i.v.). Similarly, the benzodiazepine antagonist, flumazenil (0.2 mg.kg(-1), i.v.), did not affect the suppressive effects of isoflurane. Failure of naloxone and flumazenil to reverse the suppressive effects of isoflurane suggests that isoflurane interacts with neither opioid nor benzodiazepine receptors in producing its suppressive action on nociceptive responses in dorsal horn neurons of the feline spinal cord.

Journal Article↗

PubMed1993

Significance of serum markers pepsinogen I and II for chronic atrophic gastritis, peptic ulcer, and gastric cancer.

Chronic atrophic gastritis (CAG) is closely correlated with gastric cancer and is predominant in Japan. Epidemiologically, food habits are the primary factor in both CAG and gastric cancer. Two potential serum markers for CAG have recently been investigated, i.e., the concentration of serum pepsinogen (PG) and the presence of serum antibodies against Helicobacter pylori. Serum PG I and II and the PG I:PG II ratio have been reported to be useful as indicators of recurrent peptic ulcer and for screening of patients at risk from gastric cancer. In this study, we examined PG I and II in serum from 483 patients by RIA (DAINABOT), and endoscopic examination performed in the same patients before serological assay revealed CAG in 68, peptic ulcer in 91, and gastric cancer in 48. Analysis of the mean values according to patients age showed that CAG patients in their forties to eighties had low (< 40 ng/ml) levels of PG I, peptic ulcer patients in their teens to eighties had high (> or = 70 ng/ml) levels, except for those in their seventies, and gastric cancer patients in their twenties to sixties had low (< 3.0) PG I:PG II ratios, except for those in their sixties. Thus serum PG assay has potential utility for detection of CAG, peptic ulcer, and gastric cancer.

Adolescent↗

PubMed1993

Antitumor activity of oenothein B, a unique macrocyclic ellagitannin.

The antitumor effect of oenothein B, a macrocyclic ellagitannin from Oenothera erythrosepala Bordas, on rodent tumors was studied. Oenothein B exhibited a strong antitumor activity against MM2 ascites tumors upon intraperitoneal administration to the mice before or after the tumor inoculation. The tannin also inhibited the growth of Meth-A solid type tumor in mice. This antitumor effect of the tannin could not be attributed to its direct cytotoxic action on tumor cells, because the cytotoxicity was very weak in the presence of serum protein. When oenothein B was injected into the peritoneal cavity of mice, peritoneal exudate cells, including cytostatic macrophages, were induced. Furthermore, in the in vitro treatment of macrophages from mice and humans, the tannin stimulated release of an interleukin 1 (IL-1)-like activity and IL-1 beta from the cells. These results suggest that oenothein B exerts its antitumor effect through potentiation of the host-immune defense via activation of macrophages.

Animals↗