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Biomedical subjects

T Ueno

Publications and source records attributed to T Ueno.

At least 289 records · Page 16Linked to original sources
PubMed1996

Pancreatic juice output after pancreatoduodenectomy in relation to pancreatic consistency, duct size, and leakage.

BACKGROUND: A soft pancreas with a main pancreatic duct (MPD) with normal diameter has been considered a high risk for pancreatic anastomotic leakage because of a relatively high output of pancreatic juice, but data are lacking. METHODS: An attempt was made to assess the relationship between the consistency of the pancreas, MPD diameter, pancreatic juice output, and pancreatic leakage after partial pancreatoduodenectomy. The pancreatic parenchyma was classified as of soft, intermediate, and hard consistency in 70 consecutive patients undergoing operation (groups 1, 2, and 3, respectively) by one surgeon. The MPD diameter was determined by means of endoscopic pancreatography or abdominal ultrasonography. Pancreatic juice output was measured for 21 days after operation by using a catheter inserted into the MPD. Anastomotic leakage was identified radiologically by using contrast medium. RESULTS: The mean (SD) pancreatic juice output during a period of 10 days (postoperative days 5 to 14) was 1554 (1073) ml in group 1 (n = 29), 1513 (1060) ml in group 2 (n = 13), and 187 (220)ml in group 3 (n = 28) (groups 1 and 2 versus group 3, p < 0.0001). The MPD diameter was 3.0 (1.6) mm in group 1, 5.9 (2.5) mm in group 2, and 6.6 (2.6) mm in group 3 (group 1 versus groups 2 and 3, p = 0.0001). Anastomotic leaks occurred in four (14%) patients in group 1, three (23%) in group 2, and none in group 3 (p < 0.05). CONCLUSIONS: Patients with a pancreatic parenchyma with an intermediate or normal consistency produced more pancreatic juice and had a higher leak rate.

Adult↗
PubMed1996

Significance of serum tissue inhibitor of metalloproteinases-1 in various liver diseases.

BACKGROUND/AIMS: This study was performed to assess the significance of elevated serum tissue inhibitor of metalloproteinases-1 concentration in various liver diseases. METHODS: Tissue inhibitor of metalloproteinases-1 levels were measured in patients with various liver diseases, and were compared with serum type III procollagen-N-peptide (P III P), type IV collagen and laminin P1 levels, as well as with the histology of liver biopsy specimens. RESULTS: Mean tissue inhibitor of metalloproteinases-1 levels were significantly higher in subjects with acute viral hepatitis, cirrhosis, alcoholic hepatitis, and alcoholic cirrhosis than in the control group (p < 0.05). Serum tissue inhibitor of metalloproteinases-1 levels in the various liver diseases showed positive correlation with serum type IV collagen, P III P, and laminin P1 levels. Regarding the relationship between tissue inhibitor of metalloproteinases-1 and liver histology, serum tissue inhibitor of metalloproteinases-1 levels correlated with the degree of hepatic fibrosis and inflammation, such as focal necrosis and cell infiltration. Furthermore, elevated serum tissue inhibitor of metalloproteinases-1 levels were especially related to the cell infiltration, focal necrosis, portal fibrosis, and serum type IV collagen level. CONCLUSIONS: These findings suggest that the measurement of the serum tissue inhibitor of metalloproteinases-1 level in various liver diseases may be useful to estimate the active hepatic fibrogenesis associated with the active inflammatory stage of the liver injury.

Adult↗
PubMed1996

Aminophylline reduces cardiac ischemic pain during percutaneous transluminal coronary angioplasty.

OBJECTIVES: We investigated the effect of aminophylline, an antagonist of the adenosine P1 receptor, on cardiac pain experienced during percutaneous transluminal coronary angioplasty (PTCA). BACKGROUND: Adenosine may mediate cardiac pain because the administration of adenosine provokes cardiac pain like angina. However, it is not known whether endogenous adenosine released during myocardial ischemia is responsible for cardiac pain. METHODS: This was a single-blind, placebo-controlled randomized study. Of 21 men with stable effort angina with one-vessel coronary artery disease who underwent balloon inflation four times during PTCA, 11 received intravenously administered aminophylline before the fourth balloon inflation and the other 10 were given saline solution. The severity of cardiac pain based on the pain score and ST segment elevation on standard surface and intracoronary electrocardiograms were assessed. RESULTS: All patients experienced cardiac pain during balloon inflation. Aminophylline significantly prolonged the duration of both the symptom-free interval (from 42 +/- 13 to 64 +/- 27 s, mean +/- SD, p < 0.05) and inflation time (from 79 +/- 23 to 103 +/- 20 s, p < 0.05), and it significantly reduced the pain score from 7.6 +/- 1.4 to 4.6 +/- 2.3 (p < 0.01). However, aminophylline did not affect ST segment elevation. Saline solution did not affect any of these variables. Balloon diameter and pressure were not different between the third and the fourth inflation in either group. CONCLUSIONS: Aminophylline significantly reduced the severity of cardiac pain during PTCA without affecting ST segment elevation. These findings suggest that the activation of P1 receptors by endogenous adenosine may be partially responsible for cardiac pain during ischemia.

Aminophylline↗
PubMed1996

Simple method for detection of Clostridium botulinum type A to F neurotoxin genes by ploymerase chain reaction.

A polymerase chain reaction (PCR)-based method was established to detect each type of neurotoxin genes of Clostridium botulinum types A to F by employing the oligonucleotide primer sets corresponding to special regions of the light chains of the neurotoxins. In this procedure, the PCR products were easily confirmed by restriction enzyme digestion profiles, and as little as 2.5 pg of template DNAs from toxigenic strains could be detected. The specific PCR products were obtained from toxigenic C. botulinum types A to F, a type E toxin-producing C. butyricum strain, and a type F toxin-producing C. baratii strain, but no PCR product was detected in nontoxigenic strains of C. botulinum and other clostridial species. The neurotoxin genes were also detected in food products of a seasoned dry salmon and a fermented fish (Izushi) which had caused type E outbreaks of botulism. Therefore, it is concluded that this PCR-based detection method can be used for the rapid diagnosis of botulism.

Base Sequence↗
PubMed1996

Monoclonal antibodies to rabbit hepatocyte myosin that cross-react with human liver myosin.

We prepared polyclonal and monoclonal antibodies against myosin purified from rabbit hepatocytes. Immunoblotting analyses revealed that the polyclonal antibody and four (HM1, HM2, HM3 and HM4) of five monoclonal antibodies reacted with myosin heavy chain. Chymotryptic cleavage of myosin yielded a 130 kDa fragment comprising the tail portion of the myosin heavy chain and a 67 kDa fragment comprising the ATP-binding active site of the myosin head. All active antibodies reacted with epitopes localized in the 130 kDa fragment. Monoclonal antibodies HM3 and HM4 and the polyclonal antibody reacted strongly with myosin heavy chains from a human liver homogenate prepared from a surgically resected liver specimen. Immunocytochemical analyses showed that myosin is localized along the plasma membrane as well as around the bile canaliculi in both rabbit and human hepatocytes. Immunocytochemical analyses on liver blocks obtained from those patients who suffered various types of diseases accompanying cholestasis clearly indicated a marked increase in pericanalicular myosin. This altered myosin localization is analogous to that observed in phalloidin-treated liver. Thus, myosin localization, determined using these antibodies, can provide a valid morphological basis for diagnosing the pathological state of the patient liver.

Adult↗
PubMed1996

Polyethylene glycol-modified pokeweed mitogen (PWM) as a potential non-immunogenic stimulator of lymphokine-activated killer cells.

Among the various plant lectins, pokeweed mitoge (PWM) is most effective in enhancing the cytotoxicity of human lymphokine-activated killer (LAK) cells. However, the use of PWM in adoptive immunotherapy has been limited due to the strong immune response against the protein of plant origin. Amino groups in PWM was modified with 2,4-bis[O-methoxypoly(ethylene glycol)]-6-chioro-s-triazine, activated PEG2, to form PEG-PWM conjugates. Its immunoreactivity towards anti-PWM antibodies was reduced by increasing the degree of modification of amino groups in PWM. PEG-PWM, in which 54% of amino groups in PWM was modified with activated PEG2, had a nearly complete reduction of immunoreactivity. Intraperitoneal administration of PEG-PWM to mice did not produce substantial levels of anti-PWM antibodies. Nevertheless, PEG-PWM retained the ability to induce the maximum levels of cytotoxicity of human LAK cells in vitro.

Animals↗
PubMed1996

Relationship between the amount of propranolol permeating through the stratum corneum of guinea pig skin after application of propranolol adhesive patches and skin irritation.

In the present study we evaluated the relationship between the cumulative amount of propranolol permeating through the stratum corneum and the formation of erythema, a skin irritation reaction, after transdermal application of adhesive patches containing propranolol to the skin of guinea pigs. The intensity of erythema was expressed in terms of a* values measured with a chromameter. The a* values increased in guinea pigs after application of the adhesive patches containing 0.4 mg/cm2 of propranolol to the skin. Since the adhesive patches showed good adhesion to the skin (propranolol content is less than the saturated concentration in the adhesive base) and the cumulative amount of propranolol permeating through the stratum corneum is small, the development of erythema was considered to be mainly due to physical factors such as peeling. Even in adhesive patches containing 0.8 mg/cm2 or 1.2 mg/cm2 of propranolol, a* values increased, although adhesion to the skin is low because of crystallization of propranolol in the adhesive base. On the other hand, in these two adhesive patches, the cumulative amount of propranolol permeating through the stratum corneum increased up to 24 h after application. These findings suggest that the skin irritation reaction is due to propranolol mainly absorbed transdermally, because there is a high correlation between the cumulative amount of propranolol permeating through the stratum corneum and the a* values (r = 0.928).

Administration, Cutaneous↗
PubMed1996

Bioactive saponins and glycosides. II. Senegae Radix. (2): Chemical structures, hypoglycemic activity, and ethanol absorption-inhibitory effect of E-senegasaponin c, Z-senegasaponin c, and Z-senegins II, III, and IV.

Following the characterization of E-senegasaponins a and b and Z-senegasaponins a and b, new bioactive saponins named E-senegasaponin c and Z-senegasaponin c were isolated from Senegae Radix, the root of Polygala senega L. var. latifolia TORREY et GRAY., together with Z-senegins II, III, and IV. The chemical structures of E and Z-senegasaponins c and Z-senegins II, III, and IV were elucidated on the basis of chemical and physicochemical evidence, and the geometrical isomeric structures of the 4"-methoxycinnamoyl and 3",4"-dimethoxycinnamoyl groups in these saponins were found to show tautomer-like behavior under irradiation with fluorescent lamps. E and Z-Senegasaponins c and E and Z-senegins II, III, and IV were found to exhibit hypoglycemic activity in the oral D-glucose tolerance test. (E) and (Z)-Senegins II also showed an inhibitory effect on alcohol absorption in rats.

Absorption↗
PubMed1996

[Atherosclerosis regression in the elderly--correlation between centrally depressed lesions and risk factors].

Atherosclerotic plaque with central depression (depressed lesion) may indicate regression of atherosclerosis in the aorta. Aortic depressed lesions have a solitary elevated area of plaque with a sharply-bordered roung depression in its center and no area ulceration. This may be interpretable as a sign of regression of atherosclerosis. To clarify the pathogenesis of depressed lesion, we studied clinical risk factors such as hypercholesterolemia in patients with depressed lesions that were confirmed at autopsy. The patients were divided into 3 groups according to their total cholesterol level at autopsy: a high-risk group (> or = 220 mg/dl), a moderate-risk group (180-220 mg/dl), and a low-risk group (< or = 180 mg/dl). Depressed lesions were found in 16.4% of those in the high-risk group, in 14.6% of those in the moderate-risk group and in 69.0% of those in the low-risk group. Severe aortic atherosclerosis was found in 69.8% of the patients; 50.9% of those with severe disease were in the-low risk group. Depressed lesions were also found in those with low levels of low-density lipoprotein cholesterol (< or = 140 mg/dl), 58.8% of whom were found to have severe atherosclerosis. There was no relationship between total cholesterol level and the presence of depressed lesions. However, a clinical prevention trial may result in sufficient control of ahterosclerosis among those in the high-risk group and may also lead to regression of aortic lesions.

Aortic Diseases↗
PubMed1996

Influence on isometric muscle contraction during shoulder abduction by changing occlusal situation.

Many studies have been performed on the mandibular orthopedic repositioning appliance (MORA) as an athletic performance enhancer since the late 1970s. The concept that changing the mandibular position would increase the strength and improve the performance of subjects has been a source of controversy among various researchers. The strength of shoulder abduction and electronic activities of six muscle groups in the upper body were tested on seven subjects in this study. The normalized data for four different situations: rest position, MVC (Maximum Voluntary Contraction) in an intercuspal position, MVC with placebo, and MVC with MORA in supported rest position were analysed. Statistical analysis demonstrated that the MVC with MORA was significantly stronger than the rest position for upper appendage strength. The electronic activities of all muscle groups were significantly greater with MORA than those in rest position, and some of them were significantly greater with MORA than with either MVC or placebo situation. THe results suggested that the muscle activities of the upper appendage were increased by biting MORA in the supported rest position during the shoulder abduction performance.

Adult↗
PubMed1996

[Surgery for acute type A aortic dissection associated with Marfan syndrome].

Recently, extended operation has been recommended for aortic dissection associated with Marfan syndrome. However, the operation for acute type A aortic dissection associated with Marfan syndrome is controversial. Between May 1985 and July 1994, 5 patients associated with acute type A aortic dissection and Marfan syndrome underwent surgical repair. CT examination on all patients, the survivors of the initial operation, revealed a gradually enlarged residual pseudolumen. 2 patients who underwent aortic root reconstruction and ascending aortic replacement for the initial operation eventually had to undergo aortic arch repair. From the results of this study and the improvements of intraoperative cerebral protection, we recommend aortic arch repair with aortic root reconstruction and ascending aortic replacement on initial emergency operation for acute type A aortic dissection associated with Marfan syndrome.

Acute Disease↗
PubMed1996

[An aortic valve-sparing operation (David's operation) for a patient with annulo-aortic ectasia (AAE) and aortic regurgitation (AR)--evaluation by intraoperative endoscopy].

Now, the standard operation for a case with AAE and AR is the composite graft replacement. In this case, an aortic valve sparing aortic root reconstruction, the so-called David's operation, and the intraoperative endoscopic study were performed. In the case of 68-year-old male with AAE and AR, the aortic valve was reimplanted in a tubular Dacron graft and coronary arteries were reconstructed with the Carrel patch technique. After the completion of the aortic root reconstruction, intraoperative endoscopic study revealed the disappearance of AR. Postoperative aortography revealed trivial AR and at present, seven months postoperatively, this patient have been uneventful. In this paper, we discuss the merits and demerits of the David's operation and the effectiveness of intraoperative endoscopic study for the aortic valve sparing operation.

Aged↗
PubMed1996

Comparative hemolysis study of clinically available centrifugal pumps.

Centrifugal pumps have become important devices for cardiopulmonary bypass and circulatory assistance. Five types of centrifugal pumps are clinically available in Japan. To evaluate the blood trauma caused by centrifugal pumps, a comparative hemolysis study was performed under identical conditions. In vitro hemolysis test circuits were constructed to operate the BioMedicus BP-80 (Medtronic, BioMedicus), Sarns Delphin (Sarns/3M Healthcare), Isoflow (St. Jude Medical [SJM]), HPM-15 (Nikkiso), and Capiox CX-SP45 (Terumo). The hemolysis test loop consisted of two 1.5 m lengths of polyvinyl chloride tubing with a 3/8-inch internal diameter, a reservoir with a sampling port, and a pump head. All pumps were set to flow at 6 L/min against the total pressure head of 120 mm Hg. Experiments were conducted simultaneously for 6 h at room temperature (21 degrees C) with fresh bovine blood. Blood samples for plasma-free hemoglobin testing were taken, and the change in temperature at the pump outlet port was measured during the experiment. The mean pump rotational speeds were 1,570, 1,374, 1,438, 1,944, and 1,296 rpm, and the normalized indexes of hemolysis were 0.00070, 0.00745, 0.00096, 0.00066, 0.00090 g/100 L for the BP-80, Sarns, SJM, Nikkiso, and Terumo pumps, respectively. The change in temperature at the pump outlet port was the least for the Nikkiso pump (1.8 degrees C) and the most with the SJM pump (3.8 degrees C). This study showed that there is no relationship between the pump rotational speed (rpm) and the normalized index of hemolysis in 5 types of centrifugal pumps. The pump design and number of impellers could be more notable factors in blood damage.

Blood Flow Velocity↗
PubMed1996

[Coronary artery bypass surgery in patients over 80 years].

Coronary artery bypass grafting (CABG) was being performed with increased frequency in elderly patients. However, the results of operations in patients over the age of 80 years have not been previously reported in Japan. Between May 1988 and September 1994, we have performed CABG in 28 patients over the 80 years of age (group A: mean 82.2). These patients were compared with 240 patients in 60s (group B: mean 65.0). Mean New York Association functional class (NYHA) was significantly higher in group A (p < 0.01). Left main trunk stenosis was more frequent in group A patients (p < 0.01), while the number of diseased vessels did not differ. Preoperative use of an intra-aortic balloon pump (29%) and emergency operation (54%) were more frequent in group A patients (p < 0.01). There was no significant difference in the number of grafts per patient between the groups (2.93 for group A versus 2.93 for group B), but the internal mammary artery was used more frequently in group B patients (99% versus 39%, p < 0.01). In group A, the major complicatines were stroke, cardiac tamponade, reoperatin for bleeding and respiratory failure in 1 patient each (3.6%). The hospital mortality did not differ between the groups (0% for group A and 2.9% for group B). In group A, at mean follow-up of 16.3 months, 25 patients (89%) are alive and no patient had recurrent angina. We conclude that CABG in patients over 80 years of age can be performed with low mortality and significant symptomatic benefit. Patients should not be denied CABG because of age alone.

Age Factors↗
PubMed1996

[Surgical results of elderly patients with valvular heart disease in acute surgical stage and late follow-up].

Surgical and late follow-up results were compared between 40 elderly patients over 70-years-old (group I) and 43 patients aged from 65 to 69-years-old (group II) with acquired valvular heart disease. There was one hospital death in group I, and two hospital deaths in group II. There was no difference between group I and group II in the rate of hospital mortality of the occurrence of the surgical complications. Postoperative respiratory failure did not occur even in the elderly patients with preoperatively impaired vital capacity (%VC below 60%). Postoperative cardiac function after aortic valve replacement for aortic stenosis in elderly patients more significantly improved in comparison with preoperative function. Survival rate was 62% in group I and 78% in group II from actual survival curve at 9 year after surgery by Kaplan-Meier method. Late survival rate and cardiac event free rate were not significantly different between group I and II. Surgical results in elderly patients with valvular heart disease were satisfactory.

Age of Onset↗