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Biomedical subjects

Y Okada

Publications and source records attributed to Y Okada.

At least 541 records · Page 30Linked to original sources
PubMed1998

[The efficacy of re-TUR after 3 weeks of initial TUR treatment for locally advanced bladder cancer].

BACKGROUND: Radical cystectomy was usually performed for the patient with advanced bladder cancer. The choice of surgical procedure whether bladder preserved therapy or radical cystectomy has sometime plagued us in bladder cancer treatment. Because we don't have clear guideline for the treatment of locally advanced bladder cancer (T2-T3a N0M0). We devised a radical treatment for the patients with locally advanced bladder cancer without radical cystectomy. PATIENTS AND METHODS: We performed re-TUR treatment after 3 weeks of initial TUR for 13 patients with grade 2 and locally advanced bladder cancer diagnosed with pelvic CT scan, transurethral ultrasonography or bimanual examination under the anesthesia. RESULTS: We could successfully preserve all cases of bladder with the use of this devised TUR (periods 9-45 months median 22 months). This method has significantly reduced the cystectomy rate in such locally advanced cases compared with the cystectomy rate prior to 1993 (p < 0.001). CONCLUSION: This method has significance on treatment for locally advanced papillary bladder cancer as bladder preserving therapy with careful observation.

Aged↗
PubMed1998

[Tuberous sclerosis associated with renal angiomyolipoma, pulmonary lymphangioleiomyomatosis and subungual fibroma: report of a case].

We report a case of tuberous sclerosis associated with bilateral renal angiomyolipomas (AMLs), pulmonary lymphangioleiomyomatosis (LAM) and subungual fibroma of hands and feet. A 42-year-old woman who was diagnosed as tuberous sclerosis at the age of 18 complained of left flank pain and abdominal fullness. Bilateral renal AMLs were pointed out when complete examinations were performed for hypertension at the age of 32. She suffered from severe left flank pain and abdominal distension due to the left renal tumor. Left nephrectomy and excision of the renal hilar tumor were performed. The left renal tumor weighed 1120 g, the perirenal space was filled with the tumor. histopathological diagnosis of the left renal tumor and renal hilar tumor was AML. In our case, bilateral pneumothorax appeared, and chest CT scan revealed bilateral multiple pulmonary cysts. Histopathological diagnosis of pulmonary cysts was LAM. Other complications of our case are intracranial calcification and adenoma sebaceum.

Adenoma↗
PubMed1998

[Usefulness of magnetic resonance imaging for the diagnosis of sigmoidovesical fistula: report of a case].

A 70-year-old man was given a diagnosis of sigmoidovesical fistula due to diverticulitis through the combination of examinations including cystoscopy, sigmoidoscopy, barium enema, urogram, computed tomography (CT), and magnetic resonance imaging (MRI). Among these, MRI was the most useful for the direct detection of the fistula in T1 weighted images and the confirmation of the lesion in T2 weighted images.

Aged↗
PubMed1998

[Lung transplantation: present international status and basic approach].

Lung transplantation has been established as an optional treatment for irreversible diffuse lung disease. To date, more than 8,000 patients have undergone lung transplantation, while heart-lung transplantation is confined to a very limited number of cases due to the severe shortage of donors. There are various problems in clinical lung transplantation, including limited preservation time, post-transplantation edema, acute and chronic rejection, and a shortage of donor organs. Several solutions to these problems have been found in recent experimental studies. For example, potential therapies for posttransplantation edema have been proposed, and the possibility of long-term preservation has been suggested. Research on xenotransplantation and cadaveric lung transplantation is ongoing, and this may result in options to solve the problem of the shortage of donor organs. In particular, we believe that cadaveric lung transplantation has the potential to become a clinically useful therapy in the near future.

Child↗
PubMed1998

Development and evaluation of regional health database systems.

We have developed information systems for regional public health in some areas. These systems have the following functions: (1) to register results of examinations, life style, follow-up data, diseases, (2) to output some reports and statistics for daily jobs, (3) to make a personal health database, (4) to display stored data by character, trend graph, radar chart or bar chart, (5) to analyze regional health problems, (6) to extract dada about persons with some conditions, (7) to compare data among some examinations, (8) to analyze risk factors. Each database can be transferred to mini-notebook type personal computers. So, they can be used anywhere and any time. Some access controls are performed for security. The systems are used in routine works, health consultation for persons and health education for groups. We have evaluated the systems and got some useful results. Using the systems, daily jobs can be performed with good accuracy and less labor, each subject can understand one's health status easily and clearly, grasps of health problems can be made quantitatively and health projects can be planned by scientific methods.

Aged↗
PubMed1998

Magnetic resonance imaging of the paranasal sinuses in divers.

BACKGROUND: CT and magnetic resonance imaging (MRI) frequently reveal asymptomatic paranasal sinus mucosal hypertrophy in the general population. HYPOTHESIS: Divers can suffer asymptomatic paranasal sinus mucosal injury secondary to barotrauma. METHODS: We examined 20 professional divers by MRI and compared them to 20 normal controls. Paranasal sinus mucosal hypertrophy was defined as mucosal thickening of 3 mm or greater. RESULTS: Nine divers had paranasal sinus mucosal hypertrophy vs. four controls (p = 0.09). There was no significant relationship between paranasal sinus hypertrophy and age, diving history, alcohol consumption, or smoking. CONCLUSION: Divers had a tendency toward paranasal sinus mucosal hypertrophy.

Adult↗
PubMed1998

Expression of matrix metalloproteinase 7 (matrilysin) in human osteoarthritic cartilage.

Matrix metalloproteinases (MMP) consisting of at least 16 different molecules are thought to be involved in the degradation of extracellular matrix (ECM) macromolecules under various pathologic conditions. Among them, MMP-7 (matrilysin) is unique in that it has high specific activity against various ECM components such as cartilage proteoglycan. In the present study, we examined the expression and tissue localization of MMP-7 in articular cartilages of human osteoarthritis (OA). Immunohistochemistry using a monoclonal antibody specific to MMP-7 demonstrated that the proteinase is localized to the OA chondrocytes mainly in the superficial and transitional zones in 92% of the OA cases examined (36 of 39 cases). On average, approximately 30% of the total chondrocytes (29.1%+/-30.2%) were immunostained in the positive OA cartilage samples. In contrast, MMP-7 staining was found in 8% of the normal cartilage cases (1 of 12 cases), and only a few chondrocytes (0.15%+/-0.67%) in the superficial zone were immunostained. There was a linear correlation between degree (%) of the immunostained chondrocytes and Mankin scores (rho [rho] = 0.84). Immunoblot analysis of the culture media from the cartilage explants demonstrated MMP-7 in 65% of the OA cases (15 of 23 cases) and 8% of the normal specimens (1 of 12 cases). Reverse transcription-PCR demonstrated the specific amplicon in 68% of the OA cartilage cases (17 of 25 cases), whereas only 18% of the control (2 of 11 cases) amplified the product. In situ hybridization revealed that the chondrocytes in OA cartilage express MMP-7 mRNA. MMP-7 gene expression in cultured OA chondrocytes was enhanced by the treatment with interleukin-1alpha and/or tumor necrosis factor-alpha. These data demonstrate for the first time that MMP-7 is overexpressed in human OA cartilage and suggest that cytokine-induced MMP-7 may play an important role in the degradation of ECM macromolecules in the OA cartilage.

Adult↗
PubMed1998

[Long-term results of mitral valve repair with artificial chordae tendineae].

The long-term results of mitral valve repair using artificial polytetrafluorethylene (PTFE) chordae were assessed in 61 consecutive patients with pure mitral regurgitation who underwent mitral valve repair with replacement of elongated or ruptured chordae tendineae between 1992 and 1996. There were 36 men and 25 women aged from 14 to 73 years (mean 52.1 +/- 13.8 years). The patients were followed up for between 1 to 73 months (mean 29.3 +/- 17.6 months). Fifty-five patients underwent mitral valve repair of the anterior leaflet and 6 repair of the posterior leaflet. There were two hospital and two late deaths. Actual survival rate at 5 years was 93.1%. Freedom from cardiac events at 5 years was 87.8%. Two patients required reoperation due to hemolysis. There were three occurrences of non-fatal thromboembolism. Although further investigation is necessary in a large population, expanded PTFE sutures are excellent for chordal replacement during mitral valve repair.

Adolescent↗
PubMed1998

[A case of multiple organ failure with massive intestinal bleeding caused by methicillin-resistant Staphylococcus aureus in a postcystectomy patient--efficacy of mask continuous positive airway pressure training and intraarterial embolization].

A 51-year-old man underwent radical cystectomy with tubeless cutaneous ureterostomy. Methicillin-resistant Staphylococcus aureus (MRSA) enteritis developed postoperatively. MRSA caused critical infections such as pneumonia and sepsis, which subsequently progressed to adult respiratory distress syndrome, massive melena and multiple organ failure. The patient was rescued by intensive management including mask continuous positive airway pressure, systemic vancomycin administration and intraarterial embolization to stop jejunal bleeding.

Carcinoma, Transitional Cell↗
PubMed1998

[Immunological alterations after extensive burn injury].

It is recognized that extensively burned patients have an increased susceptibility to infection and often succumb to multiple organ failure related to sepsis. Numerous investigations performed over more than 30 years have demonstrated immunologic abnormalities in burn patients, including changes in serum immunoglobulin and opsonin levels, alterations in the complement system, impairment of phagocyte and neutrophil function, suppression of delayed hypersensitive reactions, and prolongation of allograft survival. Recent progress in immunology has shown that inadequate production of both cytokines and arachidonic acid derivatives is profoundly involved in immunosuppression after severe burn injury. A better understanding of immunologic status is necessary to reduce the mortality rate from infection in extensively burned patients. This may also lead to discovering the therapeutic control mechanisms for their immunity.

Burns↗
PubMed1998

[Serial changes in mitral regurgitation after mitral valve repair with artificial chordae tendineae: assessment by transesophageal echocardiography].

Serial changes in mitral regurgitation after anterior mitral valve repair were examined by transesophageal echocardiography (TEE) in 34 of 86 consecutive patients with pure mitral regurgitation who underwent anterior mitral valve repair from 1987 to 1996. The patients were divided into two groups: 15 patients undergoing mitral repair with polytetrafluoroethylene (PTFE; PTFE group) and 19 undergoing conventional mitral repair without PTFE (non-PTFE group). The PTFE group included 11 men and 4 women with a mean age of 52.1 years. They were followed for mean 22.8 +/- 12.0 months. The non-PTFE group included 12 men and 7 women with a mean age of 53.9 years. They were followed for mean 33.9 +/- 20.4 months. Mitral regurgitation jet areas were observed at the time of operation, 1 month after mitral valve repair, and in the late follow-up period. Regurgitation jet areas were 0.7 +/- 0.7, 1.1 +/- 0.9 and 2.5 +/- 2.1 cm2 in the PTFE group, and 1.1 +/- 1.3, 2.4 +/- 1.7, 4.7 +/- 2.9 cm2 in the non-PTFE group. The jet area was significantly smaller in the PTFE group than in the non-PTFE group at 1 month after operation and in the late follow-up period. Moderate to severe regurgitation was observed in two patients (13.3%) in the PTFE group, and eight patients (42.1%) in the non-PTFE group. Mitral valve repair with PTFE showed better results than conventional mitral valve repair without PTFE during the mean follow-up period of 23 months.

Adult↗
PubMed1998

Application of the human hepatitis B virus core antigen from transgenic tobacco plants for serological diagnosis.

BACKGROUND AND OBJECTIVES: The aim was to produce HBcAg from plants more cheaply than can be done by other currently available means, and to apply such antigen to immunoassay procedures for pretransfusion testing of donor blood. MATERIALS AND METHODS: Transgenic Nicotiana tabacum cv. SR-1 plants expressing the human hepatitis B virus (HBV) core antigen (HBcAg) gene were generated by Agrobacterium-mediated transformation. The recombinant product, called tHBcAg, can assemble itself into a spherical particle with a diameter of 25 to 30 nm, and can maintain two antigenic determinants of HBcAg, namely HBc/alpha and HBc/beta. Partly purified tHBcAg was used in the hemagglutination-inhibition (HI) test, as routinely used by the Japanese Blood Center, to test a panel of 524 blood units taken from HBV-positive donors. RESULTS: In the HI test, tHBcAg showed serologic properties comparable to that from Escherichia coli, the standard antigen used in the Japanese Blood Center. CONCLUSIONS: Transgenic plants can produce reagents for serologic testing and perhaps even such medical materials as oral vaccines.

Agrobacterium tumefaciens↗
PubMed1998

[Recent progress of matrix metalloproteinase (MMP) research and its clinical application for cancer therapy].

The matrix metalloproteinases (MMPs) are a family of secreted and membrane-bound zinc-endopeptidases. These enzymes are capable of degrading the extracellular matrix, including collagens, laminin, proteoglycan and fibronectin. In some human cancers, a positive correlation has been demonstrated between MMP expression and the likelihood of developing metastasis. An imbalance between MMPs and the tissues inhibitor of metalloproteinases (TIMPs) may play a significant role in the invasive phenotype of cancers. Although TIMPs have been shown to inhibit tumor metastasis in some in vivo models, they are not suitable for pharmacologic applications due to their short half-life in vivo and large molecular size. In this paper, recent advances in MMP research and reports of clinical applications of synthetic MMP inhibitors for cancer patients are reviewed.

Humans↗
PubMed1998

[Atraumatic local interruption technique for coronary circulation in MIDCAB].

Various methods have been employed for "local" interruption of the coronary blood flow before anastomosis during MIDCAB. However, coronary artery injury caused by a snare and coronary artery stenosis at the snare site resulting in late complications have been reported. We utilize a technique that minimizes the risk of injury to the coronary artery. At about 1 cm proximal to the coronary artery incision, expanded polytetrafluoroethylene (ePTFE) suture (GORE-TEX Suture CV-3 with an 18 mm needle that is tightly curved) is placed around the coronary artery, picking up a large chunk of myocardium with the curve of the needle. A Teflon felt is then attached, and threaded through a tourniquet. The tourniquet is tightened with the minimum strength needed for hemostasis. In order to avoid damage to the distal side of the coronary artery incision, a snare is not placed. Instead, an intraluminal occluder is used to block the blood flow. Anastomosis can easily be obtained with the use of a stabilizer. Hemorrhage from passage of suture is negligible, even during administration of 1.5 mg/kg heparin, because there is no difference between the diameter of the needle and that of the thread (diameter: 0.422 mm). The thread stretches minimally along the major axis but is flexible along the minor axis and thus produces less vascular wall trauma than does polypropylene thread. Furthermore, when the coronary artery is tightened through the cushiony myocardium and the Teflon felt by the flexible GORE-TEX thread, the injury to the coronary wall is minimized.

Coronary Artery Bypass↗
PubMed1998

MR imaging of the central nervous system in divers.

BACKGROUND: Magnetic resonanse imaging (MRI) frequently reveals asymptomatic cerebral infarctions in the general population. HYPOTHESIS: The central nervous system (CNS) of divers is affected by a hyperbaric environment even if they are asymptomatic. METHODS: We examined 25 uniformed service divers by MRI and compared them with normal controls. RESULTS: Of 25 divers, 9 had CNS lesions vs. 2 of 25 controls (p = 0.02). There was a significant relationship between the CNS lesions, age, and smoking. CONCLUSION: The divers had a risk of accumulating CNS lesions. These results suggested that divers should undergo periodic medical evaluations and MRI brain scanning.

Adult↗