Biomedical subjects

T Sakurada

Publications and source records attributed to T Sakurada.

At least 19 recordsLinked to original sources

PubMed2005

[Left ventricular reconstruction on the beating heart with retrograde coronary perfusion for repair of a left ventricular aneurysm associated with aortic regurgitation: report of a case].

A 67-year-old male was undergoing hemodialysis for renal failure. He had carotid stenosis, multiple liver cysts with impaired liver function, and mild aortic regurgitation in addition to a left ventricular aneurysm with reduced left ventricular function. We used intraaortic balloon pumping with a view to maintaining cerebral and hepatic blood flow during extracorporeal circulation. However, this procedure risked increased regurgitation at the aortic valve. Therefore, after aortic cross-clamping, we performed the left ventricular reconstruction while cardiac pulsation was maintained by retrograde coronary perfusion using normothermic oxygenated blood. Coronary artery bypass grafting followed after the cross-clamp was released. The patient's postoperative progress was smooth and he was discharged on 14th postoperative day.

Aged↗

PubMed2004

Occurrence of substance P(1-7) in the metabolism of substance P and its antinociceptive activity at the mouse spinal cord level.

Substance P (SP), which is known as a pain transmitter or modulator in the spinal cord, was degraded by the synaptic membranes of the mouse spinal cord. The major metabolites of SP were phenylalanine, SP(1-6), SP(1-7), SP(1-9), SP(8-9) and SP(10-11). Degradation of SP was inhibited by a metal chelator, o-phenanthroline, and also by specific inhibitors of endopeptidase-24.11, thiorphan and phosphoramidon. In contrast, captopril (a specific inhibitor of angiotensin-converting enzyme), bestatin (a specific inhibitor of aminopeptidase) and Z-321 (a specific inhibitor of prolylendopeptidase) showed little effect on the degradation of SP. The accumulation of the major cleavage products was strongly inhibited by phosphoramidon and thirophan, as well as the initial cleavage of SP. Thus, endopeptidase-24.11 plays a major role in SP degradation in the mouse spinal cord. Additional in vivo experiments were performed to investigate the antinociceptive effect of SP(1-7), a major product of SP that was detected after incubation with spinal synaptic membranes. In the mouse tail-flick test, the intrathecal administration of SP(1-7) (1.0-4.0 pmol) increased tail-flick latency in a dose-dependent manner. These results suggest that degradation of SP by spinal endopeptidase-24.11 may lead to the formation of SP(1-7), which has an ability to produce antinociceptive effects at the mouse spinal cord level.

Analgesics↗

PubMed2004

[Induction chemotherapy and radical resection for primary nonseminomatous mediastinal germ cell tumor (NSGCT); report of a case].

A 15-year-old male was admitted to our hospital for treatment of an anterior mediastinal tumor. The tumor was visualized by chest radiography 3 months prior to admission. Computed tomography (CT) revealed a heterogeneous solid tumor located in the anterior mediastinum. Although CT-guided needle biopsy had been performed twice, histologic diagnosis could not be confirmed. We believed this tumor to be nonseminomatous mediastinal germ cell tumor (NSGCT) and started intensive chemotherapy with cisplatin (CDDP) without histologic diagnosis because his serum AFP level was rapidly increasing. After 2 courses of chemotherapy, his serum AFP level returned to the normal range and surgical resection of the tumor with part of right lung was performed. Histopathological examination revealed that the tumor consisted of mature teratoma and yolk sac tumor. He underwent 1 course of chemotherapy post-operatively because a small number of viable cells were histopathologically recognized in the yolk sac component. At the time of writing, the patient is alive without any evidence of recurrence.

Adolescent↗

PubMed2004

[Bronchioloalveolar carcinoma illustrating difficulties in diagnosis and determination of operative management; report of a case].

A 56-year-old male was admitted to our hospital to treat for an abnormal lung shadow. Computed tomography (CT) revealed the shadow with ground-glass opacity that was 30 mm in diameter at left S6 lesion. Although transbronchial lung biopsy had been performed, histological diagnosis could not be made. We had expected the tumor could not be resected completely with a partial lung resection. Additionally, he refused being done a lower lobectomy without a histological diagnosis. So we performed a S6+S* segmentectomy with No. 7-12 lymph node dissection. Although the intraoperative frozen section diagnosis was an atypical adenomatous hyperplasia, the tumor was finally diagnosed as bronchioloalveolar carcinoma (BAC) because of its nuclear atypia. We did not resect the residual part of left lower lobe because he refused the additional operation and might have histopathologically no residual tumor and lymph node metastasis. At present, he is alive without any evidence of recurrence.

Adenocarcinoma, Bronchiolo-Alveolar↗

PubMed2003

The systems biology markup language (SBML): a medium for representation and exchange of biochemical network models.

MOTIVATION: Molecular biotechnology now makes it possible to build elaborate systems models, but the systems biology community needs information standards if models are to be shared, evaluated and developed cooperatively. RESULTS: We summarize the Systems Biology Markup Language (SBML) Level 1, a free, open, XML-based format for representing biochemical reaction networks. SBML is a software-independent language for describing models common to research in many areas of computational biology, including cell signaling pathways, metabolic pathways, gene regulation, and others. AVAILABILITY: The specification of SBML Level 1 is freely available from http://www.sbml.org/

Database Management Systems↗

PubMed2003

[Re-dissection of aortic root without gelatin-resorcin-formalin (GRF) glue effect one year after aortic repair].

A 58-year-old man, who had undergone emergency graft replacement of ascending and total aortic arch using gelatin-resorcin-formalin (GRF) glue 1 year before, complained of progressive shortness of breath. Ultrasound cardiography revealed severe aortic regurgitation and dissecting aneurysm of aortic root. He underwent composite graft replacement with the aid of the right axillary artery perfusion and deep hypothermic circulatory arrest. The redissected brownish intima was identified in the area of noncoronary cusp. There was no special finding in the subsequent histopathological examination. The use of GRF glue for reconstructing the dissected aortic root is associated with a certain amount of risk of aortic wall redissection. Therefore, care should be taken to ensure proper use of GRF glue.

Aortic Dissection↗

PubMed2003

[Thoracoscopic segmentectomy of the left upper division in a patient with endobronchial hamartoma; report of a case].

A 71-year-old man was admitted to our hospital for treatment of an endobronchial tumor. Although he was asymptomatic and chest radiography showed no tumor shadow, bronchoscopic findings demonstrated an endobronchial tumor with a villous surface occluding the bronchus of the left upper division. Endobronchial resection was abandoned because we could not directly observe the cervix with a bronchoscope. In addition, because we could not diagnose the tumor histologically as benign by biopsy specimens, we elected to perform a segmentectomy of the left upper division. To reduce surgical stress, the operation was carried out using thoracoscopy. The tumor was finally diagnosed as endobronchial chondromatous hamartoma. The patient's postoperative course was uneventful. When endobronchial resection is not feasible, a less invasive surgical approach and method should be taken in patients with suspected endobronchial hamartoma.

Aged↗

PubMed2002

[Long-term results of the operation for the aortic arch aneurysm].

Between October, 1991, and October, 2001, 60 patients underwent aortic arch replacement with or without an aortic arch branched graft for atherosclerotic arch aneurysms. Their mean age was 70.1 +/- 8.6 years. Eight (13.3%) patients were operated on an emergency basis because of rupture or impending rupture of aneurysms. All operations were performed with hypothermic extracorporeal circulation. Selective cerebral perfusion for cerebral protection during aortic arch repair and systemic circulatory arrest during distal graft anastomosis was used in 56 patients. Mean selective cerebral perfusion time was 86.1 +/- 12.1 minutes. A total of 14 concomitant procedures were done. Overall in-hospital mortality was 3.3%. Postoperative temporary and permanent neurologic dysfunction were 1.6% and 1.6%. Long-term follow-up was 100% complete. There were 6 late deaths with the cumulative survival rate was 74.6 +/- 8.8%. A subsequent aortic operation was necessary for the treatment of an aortic abnormality distal to the arch in 6 patients. Reoperation free rate was 85.2 +/- 5.8%. In conclusion, cerebral protective effect of antegrade selective cerebral perfusion and total arch replacement with an aortic arch branched graft could substantially reduce in-hospital mortality and postoperative neurologic dysfunction and a satisfactory long-term results could be obtain in patients with atherosclerotic arch aneurysms.

Aged↗

PubMed2002

[Successful lingular segmentectomy using bronchoplasty in a patient with early hilar second primary lung carcinoma].

A 71-year-old man was admitted to our hospital with a small protrusive lesion at the lingular orifice of the left upper bronchus. He had undergone a right lower lobectomy and mediastinal dissection for lung carcinoma (large cell carcinoma, pT1N0M0) 14 months earlier. Early hilar squamous cell carcinoma was diagnosed by chest radiograph, CT and transbronchial biopsy. We performed a lingular segmentectomy with wedge resection of the left upper bronchus and N 1 lymph node dissection. The tumor was histopathologically diagnosed as early hilar second primary lung carcinoma. The patient's postoperative course was uncomplicated. At present, he is alive with good respiratory condition and without any evidence of recurrence. Segmentectomy is appropriate for a patient with contralateral second primary lung carcinoma as well as a patient with early hilar lung carcinoma. Bronchoplasty seems to increase the likelihood that such a patient will be a candidate for segmentectomy.

Aged↗

PubMed2002

[Cardiovascular surgery in patients with Marfan syndrome].

The natural history of patients with Marfan syndrome is depressing, however, cardiovascular surgery can improve the prognosis. We reviewed the results of this surgical procedure for 10 years. Fourteen Marfan patients underwent cardiovascular surgery for a total of 21 times. Hospital mortality was 4.8% (1 case died on the 105th day after entire thoraco-abdominal aortic replacement because of pyothorax and sepsis), and the 5- and 10-year Kaplan-Meier survival was 92.9% and 77.4% respectively. Reoperation free rate was 51.4% and 38.6% respectively. Cardiovascular surgery in Marfan syndrome can be performed with good result. Aggressive surgical management and close follow-up of patients who undergo surgery is important.

Acute Disease↗

PubMed2001

Differential antinociceptive effects induced by intrathecally administered endomorphin-1 and endomorphin-2 in the mouse.

Two highly selective mu-opioid receptor agonists, endomorphin-1 and endomorphin-2, have been identified and postulated to be endogenous ligands for mu-opioid receptors. Intrathecal (i.t.) administration of endomorphin-1 and endomorphin-2 at doses from 0.039 to 5 nmol dose-dependently produced antinociception with the paw-withdrawal test. The paw-withdrawal inhibition rapidly reached its peak at 1 min, rapidly declined and returned to the pre-injection levels in 20 min. The inhibition of the paw-withdrawal responses to endomorphin-1 and endomorphin-2 at a dose of 5 nmol observed at 1 and 5 min after injection was blocked by pretreatment with a non-selective opioid receptor antagonist naloxone (1 mg/kg, s.c.). The antinociceptive effect of endomorphin-2 was more sensitive to the mu (1)-opioid receptor antagonist, naloxonazine than that of endomorphin-1. The endomorphin-2-induced paw-withdrawal inhibition at both 1 and 5 min after injection was blocked by pretreatment with kappa-opioid receptor antagonist nor-binaltorphimine (10 mg/kg, s.c.) or the delta(2)-opioid receptor antagonist naltriben (0.6 mg/kg, s.c.) but not the delta(1)-opioid receptor antagonist 7-benzylidine naltrexone (BNTX) (0.6 mg/kg s.c.). In contrast, the paw-withdrawal inhibition induced by endomorphin-1 observed at both 1 and 5 min after injection was not blocked by naloxonazine (35 mg/kg, s.c.), nor-binaltorphimine (10 mg/kg, s.c.), naltriben (0.6 mg/kg, s.c.) or BNTX (0.6 mg/kg s.c.). The endomorphin-2-induced paw-withdrawal inhibition was blocked by the pretreatment with an antiserum against dynorphin A-(1-17) or [Met(5)]enkephalin, but not by antiserum against dynorphin B-(1-13). Pretreatment with these antisera did not affect the endomorphin-1-induced paw-withdrawal inhibition. Our results indicate that endomorphin-2 given i.t. produces its antinociceptive effects via the stimulation of mu (1)-opioid receptors (naloxonazine-sensitive site) in the spinal cord. The antinociception induced by endomophin-2 contains additional components, which are mediated by the release of dynorphin A-(1-17) and [Met(5)]enkephalin which subsequently act on kappa-opioid receptors and delta(2)-opioid receptors to produce antinociception.

Analgesics↗

PubMed2001

Involvement of spinal NK2 and NMDA receptors in aversive behavior induced by intra-arterial injection of capsaicin.

The spinal processing by which intra-arterial injection of capsaicin (CAP) induces vocalization response (VOR) was investigated in guinea pigs. Intrathecal pre-treatment with CP-96,345 (a selective NK(1) receptor antagonist, 50 nmol) did not affect the CAP-induced VOR. However, significant attenuation of the VOR was observed by intrathecal pre-treatment with a selective NK(2) receptor antagonist MEN-10,376 (40 nmol) accompanied with a significant change in the response modality. MK-801 [an N-methyl-D-aspartate (NMDA) receptor antagonist, 20 and 40 nmol] inhibited the CAP-induced VOR dose-dependently without affecting the response modalities. Furthermore, intrathecal co-treatment with 40-nmol MEN-10,376 and 40-nmol MK-801 resulted in a marked inhibitory effect on the VOR followed by a significant alteration of response modalities. Intrathecal pre-treatment with neurokinin A (NKA; a tachykinin NK(2) receptor agonist, 1 nmol) enhanced the CAP-induced VOR. These behavioral results suggested that spinal NK(2) and NMDA receptors might have priority over NK(1) receptors in the spinal processing of nociceptive information from the CAP-sensitive nociceptor.

Animals↗

PubMed2001

Antinociceptive effect of spinally injected L-NAME on the acute nociceptive response induced by low concentrations of formalin.

The formalin test has been proposed as an animal model of pain produced by tissue injury. Although biphasic nociceptive responses to formalin injection have been well documented, low concentrations (0.125 and 0.5%) of formalin injected into the mouse hindpaw produced only the phasic (acute) paw-licking response, lasting the first 5 min after the formalin injection. To explore the involvement of nitric oxide (NO) in the spinal cord and peripheral system during the acute phase of the formalin test, we examined the effect of intrathecal (i.t.) or intraplantar (i.pl.) injection of L-N(G)-nitro arginine methyl ester (L-NAME), a NO synthase inhibitor in mice. Pretreatment with L-NAME (160 nmol), injected i.t., resulted in a significant inhibition of the paw-licking response induced by 0.125 and 0.5% of formalin. L-Arginine (600 mg/kg, i.p.) but not D-arginine (600 mg/kg, i.p.) reversed the antinociceptive effect of L-NAME on the acute nociceptive response induced by low concentrations of formalin. The i.pl. injection of L-NAME (160 nmol) produced a significant decrease of the late (tonic) phase response evoked by 2.0% formalin without affecting the early (acute) phase response. Similar results have been reported in the case of i.t. injected L-NAME as assayed by the 2.0% formalin test. L-NAME (160 nmol), injected into the plantar paw, gave no significant effect on the acute nociceptive response induced by a low concentration of formalin (0.125%). These results suggest that NO in the spinal cord may be involved in not only the late phase response of the formalin (2.0%)-induced paw-licking, but also at least the acute phase response induced by low concentrations (0.125 and 0.5%) of formalin, while peripheral NO has little effect on the early (acute) phase nociceptive response evoked by formalin (0.125--2.0%) injection.

Analgesics↗

PubMed2001

Characterization of nociceptive responses and spinal releases of nitric oxide metabolites and glutamate evoked by different concentrations of formalin in rats.

A comparison was made of spontaneous nociceptive behaviors elicited by subcutaneous injection of formalin (0.5-10.0%) into the plantar or dorsal surface of the right hindpaw in rats. In the present study, we also examined the effect of paw formalin injection on the release of nitric oxide (NO) metabolites (nitrite/nitrate) and glutamate from the spinal cord in anesthetized rats using a dialysis probe placed in the lumbar subarachnoid space. Two distinct quantifiable behaviors indicative of pain were identified by formalin injected into both regions of the paw. There were no significant alterations in the number of flinches during the early and late phases induced by different regions of formalin injection. However, the early phase licking/biting activity evoked by formalin injection into the plantar surface of the paw was significantly higher than that evoked by formalin injected into the dorsal region. The maximum effect in the early and late phases was produced by 5.0% formalin injection into the dorsal and plantar paw. At a higher concentration (10.0%) of formalin, nociceptive behavioral responses were decreased except for the late phase flinching when injected into the dorsal paw. Injections of formalin (5.0%) into both regions of the paw evoked a biphasic spinal release of nitrite/nitrate with a significant increase during the early phase (0-10 min) and the late phase (30-80 or 90 min). A higher concentration of formalin (10.0%) failed to produce a clear-cut release of nitrite/nitrate. A significant increase of glutamate was observed in the 0-10 min samples obtained after injection of formalin (5.0%) into the plantar and dorsal surface of the paw, whereas 0.5 and 10.0% formalin induced no substantial release. These results suggest that 5.0% formalin should be used when studying antinociceptive activity of NO- and N-methyl-D-aspartate-related compounds in the formalin test in rats. Formalin injection into the plantar surface of the paw might prove to be useful for evoking the licking/biting response, particularly in the early phase.

Animals↗

PubMed2001

Twenty-seven-year follow-up of arrhythmogenic right ventricular dysplasia.

This case report describes clinical features, especially of surface ECG changes, observed for 27 years in a patient with arrhythmogenic right ventricular dysplasia (ARVD). The course of this patient was characterized by progressive deterioration of right ventricular function and progression of delayed potentials (so-called epsilon waves) following QRS complexes. However, the relation between ventricular arrhythmias and ECG changes or the degree of right ventricular abnormality was difficult to discern.

Adult↗

PubMed2001

[A case of Castleman lymphoma in the right pulmonary hilum and mediastinum].

A 36-year-old man who complained of low grade fever and cough was detected an abnormal shadow in the right pulmonary hilum and mediastinum on a chest X-ray film. On admission, laboratory data showed high CRP and hyper gamma globlinemia. In thoracotomy, original tumor and mediastinal lymph node were resected. Histopathologically, main tumor and two of all the resected lymph node were diagnosed as Castleman lymphoma (plasma cell type). We consider that not only the main tumor and also the peripheral lymph node should be resected in this disease, because the lesions were often showed multicentric if this tumor were plasma cell type.

Adult↗

PubMed2001

[A resected case of multiple lung cancers].

A 78-year-old man was admitted to our hospital because of abnormal shadows on chest film. A 20 x 25 mm tumor shadow was found in the right lower lung field (S10) and a 5 x 10 mm tumor shadow in the right upper lung field (S2). Bronchoscopic curettage revealed squamous cell carcinoma from the specimen on the S10 and did not revealed malignant cells from the specimen on the S2. He was performed operation, squamous cell carcinoma in the S10 was removed by right lower lobectomy and nodule in the S2 was also removed by partial resection. Histological examination confirmed well-differentiated squamous cell carcinoma from the S10 and well-differentiated adenocarcinoma from the S2. He is healthy three year after operation.

Adenocarcinoma↗

PubMed2001

[Endoventricular circular patch plasty (dor operation) for postinfarction left ventricular aneurysm and ischemic cardiomyopathy].

The determination of purse-string suture line is one of the most important point in endoventricular circular patch plasty (Dor operation) for postinfarction left ventricular aneurysm (LVAN), especially for ischemic cardiomyopathy (ICM). We suggest following three points to decide appropriate suture line. First, the purse-string suture on the basal side should be placed on the 1-2 cm level under diagonal branch. Secondly, lateral wall should not be over excluded to maintain left ventricular function. And the third, akinetic or dyskinetic lesion of apex and septal wall should be excluded as much as possible. Nine cases of five LVAN and four ICM were underwent Dor operation in our institute from Dec. 1999 to Jan. 2000. All patients were weaned from cardiopulmonary bypass easily except one patient, who was operated under IABP support, because of his preoperative severe heart failure. All patients recovered well without any serious complications and postoperative left ventricular graphies were satisfactory. Left ventricular ejection fraction and stroke volume index were increased from 34 +/- 17 to 55 +/- 16% and from 38 +/- 7 to 47 +/- 6 ml/m2, end-diastric and systric volume index decreased from 141 +/- 37 to 88 +/- 19 ml/m2 and from 96 +/- 41 to 41 +/- 23 ml/m2 respectively. The Dor procedure adopted our idea led to satisfactory result in hemodynamic and also in morphologic study.

Aged↗