Interleukin-6 and tumour necrosis factor during cardiopulmonary bypass.
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Acute-Phase Proteins↗
Biomedical subjects
T Sakakibara
Publications and source records attributed to T Sakakibara.
Response of right ventricular systolic function to exercise stress: effects of pulmonary vascular resistance on right ventricular systolic function.
To elucidate factors influencing responses of right ventricular systolic function to exercise stress, we evaluated the right ventricular ejection fraction and peak ejection rate with two different loading conditions, atrial septal defect and mitral stenosis, at rest and during exercise by means of gated equilibrium blood pool radionuclide ventriculography. In both atrial septal defect and mitral stenosis, strong correlations between changes in the right ventricular ejection fraction with exercise and pulmonary vascular resistance at rest (r = -0.97, p < 0.001; r = -0.86, p < 0.005: respectively) were found. Significant correlations between changes in the right ventricular peak ejection rate with exercise and pulmonary vascular resistance at rest (r = -0.85, p < 0.05; r = -0.75, p < 0.01: respectively) were found in atrial septal defect and mitral stenosis. Both the right ventricular ejection fraction and peak ejection rate were lower during exercise than at rest when pulmonary vascular resistance at rest was more than 200 dynes.sec.cm-5.m2 in both atrial septal defect and mitral stenosis. In conclusion, right ventricular systolic function responding to exercise stress was influenced by the pulmonary vascular resistance in both atrial septal defect and mitral stenosis.
Adult↗
Inhibition of gastric cancer cell proliferation by antisense oligonucleotides targeting the messenger RNA encoding proliferating cell nuclear antigen.
Proliferating cell nuclear antigen (PCNA) is a nuclear protein that regulates DNA synthesis by DNA polymerase delta, and is essential for DNA replication. PCNA expression level is related to the malignancy of gastric cancer cells. Seven different gastric cancer cell lines and two kinds of control cell lines were treated with antisense oligonucleotides complementary to the messenger RNA of PCNA. Treatment of each gastric cancer cell line with antisense oligonucleotides at concentration of 10-40 microM inhibited the cell growth, colony formation and PCNA protein production in a dose-dependent manner, but only affected normal cells slightly. A random sequence oligomer showed no effect. These results show that PCNA is essential for gastric cancer cell proliferation and that the use of synthetic oligonucleotides is an effective way of producing antisense-mediated changes in the behaviour of human gastric cancers.
Base Sequence↗
[Advance and practice of treatment for pump failure].
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Cardiac Output, Low↗
[A successful use of VAS for bridge to heart transplantation after oversea transportation in a 18-year-old patient with dilated cardiomyopathy].
An 18-year-old boy with dilated cardiomyopathy developed a relatively rapid deterioration and went into severe congestive heart failure. After short-while use of percutaneous cardiopulmonary support system (PCPS) and IABP, LVAS was indicated because of persisting low cardiac output syndrome and deterioration of organ functions. An LVAS (TOYOBO) was implanted on June 26, 1992 in a fashion of left atrium to ascending aorta bypass. Satisfactory circulatory support (flow rates of 4-5 L/min) was achieved resulting in complete recovery of the organ functions. After two months of LVAS support, the patient was transported to U.S.A.. The LVAS system was working well without any problems during 17 hrs flight under low atmospheric pressure (0.8 atm) in the plane. The patient successfully underwent heart transplantation (HTx) at Texas Heart Institute after 119 days support of LVAS. The patient is doing well enjoying active life after HTx. This is the first case of successful bridge use of extracorporeal LVAS to HTx in Japan.
Adolescent↗
[Isolation of Bordetella pertussis from patients with pertussis-like symptoms and estimation of vaccine efficacy].
In order to investigate the distribution of Bordetella pertussis in Nagoya City and estimate efficacy of the vaccine, we tried to isolate B. pertussis from patients with Pertussis-like symptoms who went to the department of pediatric general hospitals in Nagoya City from 1989 to 1992. B. pertussis were isolated from 43 patients among 164 patients with Pertussis-like symptoms. All of these isolates were classified into 1, 3, 6 serotype. It was impossible to isolate any B. pertussis in 1992 because of yearly variations. B. pertussis was only isolated from patients who were not vaccinated. Among the 28 siblings of the patients, 18 were vaccinated and 2 fell ill, but the latter had only mild symptoms. Three did not fall ill although they had an incomplete vaccination. According to these results we suggest that this component vaccine is effective.
Bordetella pertussis↗
[Survival of patients with gastric cancer treated with intra-lymph nodal injection of activated carbon particles absorbed mitomycin C].
We studied the efficacy of the intra-lymph nodal injection of the activated carbon particle absorbed mitomycin C (MMC-CH40) for gastric cancer. Ninety-five patients with gastric cancer underwent gastrectomy with D1 or D2 lymph node dissection. Of these, 38 patients were treated with intra-lymph nodal injection of MMC-CH 40 (MMC-CH 40 group). The other 57 patients were classified into the control group. The survival of MMC-CH group was significantly higher than that of the control group using generalized Wilcoxon method. However, since the percentage of stage IV was higher in the control group than in MMC-CH 40 group, the survivals of subgroups of stage I-III were compared. Although the percentage of the early gastric cancer was higher in the control group of stage I-III (n = 35) than in the MMC-CH group of stage I-III (n = 38), the survival curves of MMC-CH group were higher than in the control group. The difference in survival between the two groups was significant at 8 months after surgery. These results indicate that this new therapy improves survival in patients with stage I-III gastric cancer.
Absorption↗
[Successful treatment of advanced gastric cancer (Borrmann 1 type) with FTP chemotherapy after reduction surgery].
A 54-year-old man was diagnosed with Borr 1 type gastric cancer, located just below ECJ with some paraaortic lymph node metastase, during treatment of diabetes mellitus at another hospital. He underwent spleno-total gastrectomy for reduction. The metastatic lymph nodes of the para-aorta were not resected, so the surgery was considered palliative. We administered FTP chemotherapy (CDDP 110 mg/day 1, 5-FU 1,200 mg/day 1-5, THP-ADM 30 mg/day 1) 5 times following surgery. The metastatic lymph nodes were remarkably decreased in size by the initial treatment. The decrement was 52.4% after the initial treatment (PR). After the 4th treatment, there were no lymph nodes detected (CR). After the 5th treatment, CR continued. The PR period was considered to be 5 months, and that of CR 4 months. The patient has no renal or heart dysfunction, and no suppression of bone marrow. His quality of life is satisfactory, and he continues to work as prior to surgery. FTP chemotherapy is considered a successful regimen for postoperative chemotherapy.
Adenocarcinoma, Papillary↗
The effect of prostaglandin E1 during cardiopulmonary bypass on renal function after cardiac surgery.
We have evaluated the effect of prostaglandin E1 (PGE1) on renal function after cardiac surgery with cardiopulmonary bypass in 20 patients, ten of whom received 0.02 microgram.kg-1.min-1 of PGE1 by infusion into the oxygenator during bypass; ten patients served as controls. Serum beta 2-microglobulin fell significantly and urine beta 2-microglobulin increased significantly after surgery in both groups. Urine N-acetyl-beta-D-glucosaminidase was high after surgery in both groups, but it was significantly lower in the PGE1 group. Free water clearance fell significantly on the 1st, 3rd, and 5th postoperative days compared with preoperative values in the control but not in the PGE1 group. These results suggest that PGE1 may prevent renal dysfunction after cardiopulmonary bypass.
Acetylglucosaminidase↗
Chronic progressive sensory ataxic neuropathy: clinicopathological features of idiopathic and Sjögren's syndrome-associated cases.
Eleven patients with chronic progressive sensory ataxic neuropathy were examined clinicopathologically. Three cases were associated with primary Sjögren's syndrome (SS-SAN) and the others were considered to be idiopathic (ISAN). The major clinical symptom in both was loss of proprioceptive and kinesthetic sensation with some impairment of superficial sensation, with multifocal and asymmetrical distribution and progression. The truncal and trigeminal nerves were frequently involved. The motor system was substantially preserved. These somatic sensory and motor symptoms did not differ between ISAN and SS-SAN, but autonomic nervous system signs were more frequent in SS-SAN. Polyclonal elevations of serum IgG and/or IgA were seen in 8 patients. One autopsied case with ISAN combined with previous reports suggested that systemic T- and B-cell infiltration into the nervous tissues, as well as a wide variety of the visceral organs, may be a common finding in ISAN and SS-SAN, and could participate in the cause of this neuropathy and polyclonal hypergammaglobulinaemia.
Aged↗
Supported angioplasty with synchronized retroperfusion in high-risk patients with left main trunk or near left main trunk obstruction.
To test the feasibility of synchronized retroperfusion (SRP) as a support device of percutaneous transluminal coronary angioplasty (PTCA) for high-risk patients, 10 patients with left main trunk or near left main trunk obstruction underwent PTCA with SRP. An 8.5F retroperfusion catheter was inserted from the antecubital vein into the coronary sinus. Arterial blood was supplied through the catheter into the myocardium with a retroperfusion pump during the diastolic phase by means of ECG triggering. In all patients, the narrowings were successfully dilated and an improvement of more than 20% in the luminal diameter stenosis was achieved; however, narrowing of more than 50% (58%) remained in one patient. In all patients, systemic hemodynamics was maintained for more than 30 seconds during balloon inflation. In seven patients, a 60-second balloon inflation was possible without any collapse of systemic hemodynamics. To test the protective effect of SRP on myocardial ischemia and impairment of systemic hemodynamics, balloon inflation without SRP was performed in eight patients after successful dilatation. The duration for balloon inflation with SRP (71 +/- 30 seconds; n = 8) was significantly longer than that without SRP (56 +/- 30 seconds; n = 8). The decrease in systolic aortic pressure, the increase in pulmonary diastolic pressure, and ST-T segment elevation in the precordial lead of ECG during balloon inflation with SRP were less than those during balloon inflation without SRP. After PTCA, angina was not provoked by exercise stress testing in any of the 10 patients. We concluded that SRP is a beneficial support device of PTCA for high-risk patients.
Aged↗
The effect of prostaglandin E1 on renal function after cardiac surgery involving cardiopulmonary bypass.
This study was performed to evaluate the effect of prostaglandin E1 (PGE1) on renal function after cardiac surgery in patients undergoing cardiopulmonary bypass (CPB). Haemodynamic and renal functional response to low dose PGE1 (0.02 microgram kg-1 min-1) (group A) or saline (group B) infusion via peripheral vein during CPB was evaluated in 20 patients who underwent cardiac surgery. The perfusion pressure was maintained at about 60 mmHg during CPB in both groups. Urine beta 2-microglobulin (UBMG) (P < 0.01), and urine N-acetyl-beta-D-glucosaminidase (NAG) (P < 0.05) demonstrated significantly high values after CPB in both groups compared with the presurgical value. Free water clearance (CH2O) decreased significantly at the first postoperative day compared with the pre-surgical value in both groups (P < 0.01). Statistical analysis of NAG, UBMG and CH2O demonstrated significant differences between both groups, in CH2O values at the third (P < 0.05) and fifth days (P < 0.05) after surgery, in NAG values at the fifty (P < 0.01) and seventh days (P < 0.01), and in UBMG values at the first (P < 0.05) and third (P < 0.05) postoperative day, respectively. Cardiac output (co) did not change in either group throughout this study. Pulmonary capillary wedge pressure (PCWP) in group A decreased significantly at 30 and 60 min after CPB, but in group B did not change throughout the study. Cardiac index (CI) decreased significantly at 60 min after CPB in group A (P < 0.05) and at 30 min in group B (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
Urodynamic evaluation of results of endopyelotomy for ureteropelvic junction obstruction.
We treated 13 patients with unilateral ureteropelvic junction obstruction by percutaneous endopyelotomy, and they were urodynamically evaluated by the Whitaker test and diuresis renography, in addition to excretory urography (IVP). Surgery was uncomplicated in all patients except 1 who required repeat incision 4 weeks later. Obstruction was diagnosed preoperatively by the Whitaker test and diuresis renography in 10 cases, and by IVP in 13. Postoperatively, all 10 patients (100%) with a positive Whitaker test were free of obstruction with a significant reduction in the relative renal pelvic pressure from 35.0 to 8.1 cm. water (p < 0.01). Diuresis renography revealed no obstruction in 8 patients (80%) and persistent obstruction in 2. IVP demonstrated reduced hydronephrosis in 8 of 13 patients (62%) 12 weeks after surgery and in 11 of 13 patients (85%) 19 months later. However, a marked reduction in renal pelvic size was noted in only 3 patients (23%). Flank pain disappeared in 10 of 11 patients (91%) postoperatively. Overall, surgery was successful in 11 of the 13 patients (85%). Percutaneous endopyelotomy was effective in relieving obstruction at the ureteropelvic junction with minor morbidity. The Whitaker test was more sensitive for evaluating the results of surgery than diuresis renography and IVP, although diuresis renography appears to be useful in followup evaluation of hydronephrosis.
Adolescent↗
Cisplatin microcrystals suspended in oil--toxicity in mice.
A new dosage format, cisplatin microcrystals suspended in oil (CDDP-oil), was developed for the treatment of peritoneal carcinomatoses. We studied the acute toxicity of CDDP-oil injected intraperitoneally in mice. The 50% lethal dose was 30.3 mg/kg (27.1-33.7 mg/kg at the 95% confidence level), which was 1.79 times that of a cisplatin aqueous solution (CDDP-sol) of 16.9 mg/kg (16.1-17.8 mg/kg at the 95% confidence level). There were no significant differences in the duration of the toxic effects and the toxic symptoms between these two dosage forms. However, the severity of weight loss in the group given CDDP-oil was less than the group given CDDP-sol.
Animals↗
Roentgenographic findings of the cervical spine in tension-type headache.
Roentgenographic studies were carried out on 372 patients with tension-type headache and 225 normal control subjects to determine relationships between straightened cervical spines, low-set shoulders, and cervical spine instability. A great majority of the patients with tension-type headache were found also to have straightened cervical spine. Patients with tension-type headache may have a restricted progression of the cervical spinal lordosis, which results in a straightened cervical spine. The flexor muscles of the head and neck prevent physiological lordosis of the cervical spine, and their sustained chronic contraction may be a principal cause of a straightened neck. The low-set shoulder was frequently seen in patients with tension-type headache, and it may result in traction of the brachial plexus, which gives rise to pain in the neck and shoulders. Cervical spine instability, on the other hand, was rather infrequent in patients with tension-type headache. Its relationship to tension-type headache is unclear and warrants further study. Our results suggest that both a straightened cervical spine and low-set shoulders may play an important role in the pathogenesis of tension-type headache and its accessory symptoms.
Adolescent↗
[A case of renal cell carcinoma treated by ex vivo partial nephrectomy and autotransplantation].
We report on a case of renal cell carcinoma in a functionally solitary kidney, treated by ex vivo partial nephrectomy and autotransplantation. A 62-year-old woman was admitted for examination of a left renal mass and right hydronephrosis, incidentally detected on echography and CT scan. The right hydronephrosis was caused by congenital ureteropelvic junction obstruction, associated with severely impaired renal function. A solid tumor was found in the left kidney, located in the upper pole and extending to the hilus, and was suspected to be renal cell carcinoma. The patient was treated by ex vivo partial nephrectomy of the left kidney followed by autotransplantation. The tumor was 35 x 55 x 40 mm in size and diagnosed histologically to be renal cell carcinoma. Hemodialysis was unnecessary since good urine output was obtained postoperatively from the transplanted kidney. The patient was discharged 3 months after surgery, following interferon-alpha therapy, with serum creatinine level of 1.4 mg/dl.
Carcinoma, Renal Cell↗
[Local injection of peplomycin adsorbed on activated carbon particles combined with 60Co radiation against inoperable advanced esophageal cancer--two long-term survivors].
We have developed a new dosage form, PEP-CH, consisting of peplomycin adsorbed onto small activated carbon particles. Ten patients with inoperable advanced esophageal cancer were treated with endoscopic local injection of PEP-CH combined with radiation using 60Co. Two of 5 patients who completed the treatment have survived over one year (19 and 23 months) now.
Aged↗
Clinical trials with intraperitoneal cisplatin microspheres for malignant ascites--a pilot study.
A new formulation (CDDP-MS), which is composed of lactic acid oligomer microspheres incorporating cisplatin, has been developed in a dosage form for peritoneal carcinomatosis. In this pilot study, CDDP-MS was used clinically for the treatment of malignant ascites induced by cancers of the digestive organs. Thirteen patients with malignant ascites received an i.p. administration of CDDP-MS, of which 12 received 100 mg and one received 200 mg of cisplatin/person to control the ascites. Total platinum levels in ascites and blood plasma were measured periodically. Intraperitoneal CDDP-MS decreased malignant ascites completely in eight patients and partially in four patients, and thus gave a response rate of 92%. The platinum concentration in ascites was maintained at a high level for a week after administration, whereas the concentrations in blood plasma were low. The side effects were well tolerated. Intraperitoneal CDDP-MS exhibits a marked therapeutic benefit with small systemic side effects for the treatment of malignant ascites.
Adenocarcinoma↗