Biomedical subjects

Y Ohtani

Publications and source records attributed to Y Ohtani.

At least 91 records · Page 5Linked to original sources

PubMed1995

[Myasthenia gravis: an analysis of patients with postoperative crisis after thymectomy].

Five patients with myasthenia gravis whose condition declined during the postoperative unstable period were studied. The Osserman's type, age at the time of onset, duration of illness, sex, age at the time of surgery, preoperative steroid therapy, thymoma and acetyl choline receptor antibody titers were compared with those of 21 patients (control) with myasthenia gravis who had an uneventful postoperative course. In comparison, the study group's Osserman's type was slight, age at the time of onset was older (p < 0.05) and duration of illness was shorter (p < 0.05). There was no significant difference between the groups in sex, age at the time of surgery, thymoma and acetyl choline receptor antibody titers. None of them had preoperative steroid therapy. Intensive postoperative management and careful follow-up at the postoperative unstable period are necessary particularly for patients who have slight Osserman's type, old age at the time of onset, short duration of illness and no preoperative steroid therapy.

Adolescent↗

PubMed1995

Pulmonary epithelioid hemangioendothelioma: a case report.

A 45-year-old woman whose x-ray film revealed multiple widespread bilateral small nodules was diagnosed as having pulmonary tuberculosis or metastatic pulmonary cancer. A conclusive histological diagnosis of pulmonary epithelioid hemangioendothelioma (PEH) was made following an open-lung biopsy. PEH is a progressive disease that probably originates from an endothelial cell. However, there is still no effective therapeutic modality for PEH. The postoperative course of our patient has been uneventful with no evidence of tumor growth for four and a half years after initial x-ray detection of the lesions.

Biopsy↗

PubMed1995

[Mediastinal schwannoma originating from the intrathoracic vagal nerve--a case report and review of the literature].

A 31-year-old woman was operated upon with the diagnosis of mediastinal tumor. The resected specimen revealed pathologically benign schwannoma originating from the right intrathoracic vagal nerve. The postoperative course was uneventful with no complication. Mediastinal schwannoma arising from the vagal nerve is rare. We discussed characteristics of this disease and reviewed the Japanese literature.

Adult↗

PubMed1995

[Experience and problems with home parenteral nutrition for patients with peritonitis carcinomatosa].

Since 1987, we have been using home parenteral nutrition (HPN) for patients with peritonitis carcinomatosa, who had undergone surgery for cancer of the digestive tract and who could not take food orally. We have been inserted catheterization for HPN in 90 patients. Nine of them underwent the treatment as training, but HPN was possible in the remaining 81 patients (90%). The patients in whom the treatment failed to be transferred to HPN showed worsening of their general condition during hospitalization, because the period of training was long. As a result, they could not be discharge. We considered that the timing of transfer to HPN was inappropriate. The largest number of patients, 57, had undergone surgery for cancer of the stomach and esophagus, which was the underlying disease. The mean period of HPN was 108.2 days. According to the underlying disease, the period was longest, 115.7 days, for cancer of the stomach and esophagus, followed by 93.8 days for colorectal cancer. The performed rate of HPN for 60, 90, 180 and 270 days were 56.7, 36.0, 17.9 and 6.5%, respectively, with the one-year cumulative rate of 3.3%. HPN for terminal stage of cancer is an effective treatment for patients with peritonitis carcinomatosa, and it allowed improvement in the quality of life. Cooperation with various medical staff members is also necessary and a hospital system should be established for safe and smooth achievement of the treatment method.

Ascitic Fluid↗

PubMed1995

Hepatic cytokeratin changes in obstructive jaundice: before and after biliary drainage.

We investigated the changes in hepatic cytokeratins in obstructive jaundice by immunohistochemistry. The results can be summarized as follows: 1) In accordance with the progression of the jaundice, the lobular and cellular distribution of cytokeratin reactivity in hepatocytes expanded. 2) Cytokeratin reactivity in obstructive jaundice was improved by removal of the bile duct obstruction (decompression), but this decompressive effect deteriorated in the case of prolonged jaundice. 3) It is suggested that the specific lobular and cellular distribution and/or the changes in cytokeratin aggregation might be of value in determining the stage and in predicting the prognosis of obstructive jaundice.

Animals↗

PubMed1994

Clinical studies of type-I procollagen carboxyterminal peptide in serum of patients with gastric cancer: comparison with CEA and CA19-9.

The serum level of a newly developed monoclonal antibody against type-I procollagen carboxyterminal peptide (P-1-P) was determined in patients with gastric cancer. The location of P-1-P in gastric cancer tissue was also investigated. We found that: (1) The serum P-1-P level and the positivity rate in patients with gastric cancer were similar to those in patients with other malignant or benign GI diseases and healthy individuals. (2) In patients with gastric cancer, the P-1-P positivity rate was significantly lower than that of CEA or CA19-9. (3) In patients with gastric cancer, the P-1-P positivity rate increased as the disease stage advanced. (4) Among patients with gastric cancer, the P-1-P positivity rate was significantly higher in those with scirrhous type than in those with medullary or intermediate type. (5) P-1-P was detected in the cytoplasm of cancer cells. P-1-P staining was stronger in scirrhous type and histologically undifferentiated gastric cancer. These results show that P-1-P can serve as a good marker for scirrhous type gastric cancer. The production of collagen by cancer cells themselves seems to be involved in collagen production in scirrhous type gastric cancer.

Adenocarcinoma, Scirrhous↗

PubMed1994

Biodiversity of the localization of the epitopes to connectin antibodies in the sarcomeres of lamprey, electric ray, and horse mackerel skeletal muscles.

SDS gel electrophoresis showed the presence of connectin, approximately 3000 kDa, in skeletal muscles of fishes, lamprey, electric ray and horse mackerel. The antibodies to avian or mammalian skeletal muscle connectin, 3B9 and Pc1200, reacted with all the fish connectins. However, a monoclonal antibody SM1 recognized electric ray connectin but did not react with lamprey and horse mackerel connectins. Immunoelectron microscopy revealed that the epitope to Pc1200 was localized at the periphery of the Z line of all the fish muscle sarcomeres and that to SM1 was located at the N2 line in the I band of ray muscle. These two localizations are the same as those in rabbit, chicken and frog skeletal muscles. On the other hand, the positions of epitopes to 3B9 were variable in the three classes of fishes, although all of them were localized in the A band. Some of the epitope positions were common to those in chicken skeletal muscle. Thus the present work demonstrates biodiversity of connectin in fish skeletal muscles, distinct from avian and mammalian skeletal muscles.

Animals↗

PubMed1994

Abnormal carbohydrate metabolism in cerebrospinal fluid in Rett syndrome.

We analyzed lactate, pyruvate, and citric acid cycle intermediates in cerebrospinal fluid by high-performance liquid chromatography in Rett syndrome patients (n = 27; mean age, 5.7 +/- 3.4 years) and age-matched female controls (n = 12; mean age, 7.0 +/- 3.3 years). The lactate, pyruvate, alpha-ketoglutarate, and malate were significantly elevated in Rett syndrome compared to the controls. The lactate/pyruvate ratio was not different. On the other hand, cerebrospinal fluid citrate, cis-aconitate, succinate, fumarate, and oxaloacetate were not significantly different in Rett syndrome patients than in the controls. We also evaluated the correlation between these acids and clinical symptoms and signs, including clinical stage, seizures medications (anticonvulsants or naltrexone), developmental quotient, self-abuse, and hyperventilation or apnea or both. The concentrations of all these acids did not differ significantly with clinical stage. Lactate elevation significantly correlated with apnea. Lactate and pyruvate elevation significantly correlated with hyperventilation or with both breathing abnormalities. Our observations in this sample of patients with Rett syndrome led us to speculate that patients with the Rett syndrome may have defective carbohydrate metabolism. Elevated mitochondrial reduced nicotinamide-adenine dinucleotide-linked substrates suggest that reduced nicotinamide-adenine dinucleotide-ubiquinone oxidoreductase may be deficient in the brain in Rett syndrome patients.

Brain↗

PubMed1994

[Lung cancer with pleural dissemination diagnosed by thoracofiberscopy: a case report].

Pleural dissemination was suspected in a 39-year-old woman with pulmonary adenocarcinoma. Thoracofiberscopy provided the preoperative exact diagnosis of pleural dissemination and the following prepare operative procedure. Thoracofiberscopy is effective for the diagnosis of pleural dissemination and the selection of operative methods in patients with pulmonary cancer.

Adenocarcinoma↗

PubMed1994

[A concomitant operation of coronary artery bypass grafting and thymectomy: a case report].

A 63-year-old man was successfully operated upon concomitantly for coronary artery disease and invasive thymoma. The chest roentogenogram showed a mass shadow in the anterior mediastinum, which was 6.0 x 4.0 cm in size and irregular. Coronary angiography revealed complete obstruction of the right coronary artery and 90% stenosis of the first diagonal branch (#9). Following thymectomy combined with the resection of the left phrenic nerve and the mediastinal pleura, coronary artery bypass grafting with the major saphenous vein was performed to #4 PD and #9. This is the first report of concomitant surgery for the ischemic heart disease and invasive thymoma in Japan.

Coronary Artery Bypass↗

PubMed1994

[Pulmonary resection for metastatic gallbladder carcinoma by thoracoscopic surgery--report of a case].

A 58-year-old male was admitted to our hospital 11 months after undergoing a cholecystectomy and partial hepatectomy for carcinoma of the gallbladder with direct invasion of the liver at another hospital. Three round, abnormal shadows had been detected in the lungs by chest roentgenogram, but the patient had neither been diagnosed nor treated. On admission to our hospital, we confirmed three small lesions. Before operative procedure, the lung lesions were diagnosed as adenocarcinoma by transbronchial lung biopsies via fiberoptic bronchoscope and percutaneous needle biopsies. The ipsilateral lung was collapsed during one-lung anesthesia with a Unibent tube, and thoracoscopic surgery was performed using a flexible thoraco-fiberscope and reusable thoracic surgiports of our own design. A wedge resection of the pulmonary lesion was performed by intrathoracic ENDO-DIA. A well differentiated adenocarcinoma defined as a metastasis of gallbladder carcinoma was diagnosed by resected specimen. Thoracoscopic surgery appears to be a safe, effective and less morbid alternative procedure to thoracotomy for carefully selected patients with peripheral pulmonary lesions. Further evaluation and prospective studies are indicated.

Adenocarcinoma↗

PubMed1994

[The Takeuchi procedure for anomalous origin of left coronary artery from pulmonary artery--report of an adult case].

The Takeuchi procedure was successfully performed in a 31-year-old female with anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA). The internal tunnel in the main pulmonary trunk was patient in coronary angiography and a marked improvement of coronary perfusion was demonstrated with a single photon emission CT four months after surgery. Cardiac catheterization at that time revealed mild supravalvular pulmonary stenosis with no clinical manifestation. The Takeuchi procedure may be the treatment of choice even for adults with ALCAPA if it is arising from the posterior wall of the pulmonary trunk, since a long-term patency is expected in this procedure than in coronary artery bypass grafting.

Adult↗

PubMed1994

[Long-term results after surgical repair for aged atrial septal defect].

Between 1980 and 1992, 84 patients over 30 years were underwent operative closure of atrial septal defect (ASD). Preoperative complaints and lower cardiac function were more frequent in the older than in the younger, but the clinical symptom of both generation improved significantly after surgery. Only a 67-year-old patient died after surgery due to low cardiac output syndrome. No long-term death occurred. The incidence of atrial fibrillation was increased postoperatively compared with preoperatively. Therefore, we recommend early surgical repair for aged ASD before thirties, if possible.

Adult↗

PubMed1993

On the loss of apparent motion between isolated chromatic stimuli near isoluminance.

Long range apparent motion (AM) between two isolated stimuli breaks down following prolonged inspection. Time-till-breakdown (TTB) for AM between random-dot squares (red or green) on a red random-dot background was measured as a function of luminance contrast of the stimuli against the background. For the same-color (red squares on the red background) and the different-color (green squares on the red background) conditions, TTB showed clear dependence on the luminance contrast, diminishing with decreasing the contrast. Near isoluminance (luminance contrast of approx. -14 to +14%), AM for the same-color condition disappeared, but AM for the different-color condition was clearly seen and persisted for 7-14 sec. These results show that AM can be produced by color alone. Previous controversial question on the loss of long range AM near isoluminance may be explained by taking into account the contrast dependence of the breakdown effect and the experimental procedures employed.

Color Perception↗

PubMed1993

Microanatomy of the rat diaphragm: a scanning electron and confocal laser scanning microscopic study.

The present study demonstrated the three-dimensional microstructure of the rat diaphragm by scanning electron microscopy (SEM) of either intact or alkali-treated tissues, enzyme-histochemistry, and confocal laser scanning microscopy (LSM). The peritoneal and pleural surfaces of the diaphragm were covered with mesothelial cells studded with microvilli. Many round gaps were formed between the mesothelial cells. The submesothelial connective tissue contained voluminous, irregularly shaped lymphatics. Some of these lymphatics extended many funnel-like projections of their endothelia towards the pored region of the mesothelium. On coming into contact with the mesothelium, many of the lymphatic projections were perforated at their ends, thus giving rise to stomata connecting the peritoneal cavity and lymphatic lumen. Some projections ended blindly while plugging the mesothelial pores, thereby making visible some intercellular gaps in this contact. The subperitoneal sheet of the collagen fiber network possessed clusters of foramina which tightly fit the passage of the lymphatic projections. Confocal LSM of the diaphragm after intraperitoneal injection of FITC-dextran demonstrated the tracer both in the lymphatic lumina and in the connective tissue spaces. Our results indicate that peritoneal fluid is allowed to flow into the connective tissue spaces of the diaphragm through intercellular gaps and into lymphatics through stomata.

Animals↗

PubMed1993

[Effect of extended thymectomy in myasthenia gravis of pure ocular type].

The effect of extended thymectomy in myasthenia gravis of pure ocular type was investigated in 13 patients, who were divided into the surgical group of nine and the conservative group of four. In the surgical group, the onset was at 47 +/- 20 years old. The preoperative duration of symptoms was 4 +/- 6 years. The age at the time of operation was 51 +/- 16 years old. Three patients had thymomas, including one malignant thymoma. Acetylcholine receptor antibody titer was over normal range with 34.0 +/- 49.7 nmol/l. No postoperative crisis occurred. The palliation rate of the surgical group was more higher through the whole period than that of the conservative group, and increased with progress of the course. The remission occurred in the surgical group, but did not in the conservative group. It took 7 months to improve the symptom in the surgical group, while 18 months in the conservative group. We conclude extended thymectomy is reasonable for patients with myasthenia gravis of pure ocular type.

Adult↗

PubMed1993

[Surgical treatment of elderly patients with primary lung cancer].

Fourteen patients with lung cancer over the age of 70 years had the standard operation with mediastinal lymph node dissection. Their postoperative complications and prognoses were compared with those of 47 patients under the age of 70 years with the same operation. The propriety of the standard operation with mediastinal lymph node dissection for lung cancer in elderly patients was studied. A program of respiratory training was arranged preoperatively for the patients. Preoperative complications was more common in elderly than in younger patients, but postoperative complications were less frequent. The prognosis in elderly patients was also satisfactory. We conclude that the standard operation with mediastinal lymph node dissection for lung cancer can be performed as well in elderly as in younger patients.

Adult↗

PubMed1993

[Treatment strategy of gallstone patients under special conditions gallstone in the elderly].

We have treated 894 gallstone patients for these five years. The average age was 55.47 and 163 cases (18.2%) were more than 70 year-old. One of the important characteristics of the aged gallstone patients that they often had bile duct stones causing acute obstructive cholangitis. The other was that they accompanied another organ disorders. Early biliary drainage was the best way to avoid multiple organ failure under such conditions. Principally, surgical treatment if it's possible, was most reliable for bile duct stones. Thirty-five patients of bile duct stones were treated with our new surgical procedure. That was primary closure technique of the common bile duct following lithotomy under pre- or intra-operative insertion of naso-biliary drainage catheter. Especially in the elderly, this technique was useful to reduce post operative hospital stay by 19 days compared with the ordinary T-tube drainage.

Aged↗