[Characteristics of medical institutions visited by patients with 26 intractable diseases].
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Chronic Disease↗
Biomedical subjects
Y Sakurai
Publications and source records attributed to Y Sakurai.
Detection of Sendai virus antibody in mouse and guinea pig sera by an enzyme-linked immunosorbent assay with protein A.
An enzyme-linked immunosorbent assay using horseradish peroxidase (HRPO)-labeled protein A (P-ELISA) was established for detection of Sendai virus (SV) antibody in mouse and guinea pig sera. Sensitivity and specificity of P-ELISA were compared with those of ordinary ELISA using HRPO-labeled immunoglobulin G (IgG-ELISA) and the hemagglutination inhibition (HI) test. P-ELISA was 100 to 1,000 times more sensitive than the HI test for detection of the antibody in SV-naturally infected mice. P-ELISA and IgG-ELISA showed similar sensitivities for detection of the antibody in naturally infected mouse and guinea pig sera. A high specificity was demonstrated in P-ELISA with a cut-off optical density value of 0.2 (492 nm), while a non-specific reaction was observed when IgG-ELISA was used to both mouse and guinea pig sera at a low dilution (1:10-20). The antibody in rat sera was not detected by P-ELISA although it was realized by IgG-ELISA.
Animals↗
[Clinical study of controlled-release preparation of mitomycin C in the treatment of inoperable cancer patients].
The composite substance of Mitomycin C (MMC) and polymer by low temperature radiating polymerization has a characteristic of slow release, the possibility of applying it to local chemotherapy was clinically studied. Buttom-formed preparation (MMC 20 mg) and needle-formed preparation (MMC 5 mg) were applied to the lesions, respectively, by sewing and piercing in 220 cancer patients with non resectable infiltrative lesions. The treatment had a pain-relieving effect in 70 out of 117 cases (60.0%) of painful cancer in the pancreas, biliary duct, liver, etc, and improved the symptoms of digestive organs in 31 out of 93 cases (33.3%). However, the tumor-reducing effect was recognized only in minute localized lesions of hepatic cancer, etc., and the survival period was not prolonged. The treatment caused no severe side effects. From the above results, the local chemotherapy with slow-releasing MMC preparation was concluded to be a useful means of palliative therapy in non-resectable, though its formulation may to be further improved.
Clinical Trials as Topic↗
[The study of intratumoral PO2 in brain tumors].
The aim of this study was to evaluate the hypoxic cells in the human brain tumor in vivo. Untreated 16 cases of brain tumor were analysed. During the surgery for the purpose of removal of the tumor, needle type-O2 sensors were inserted into femoral artery and in brain tumor to measure PaO2 and intratumoral O2 pressure. A plate type O2 sensor was put on the surface of surrounding brain cortex to measure cortical O2 pressure. These O2 sensors for this study is able to measure O2 pressure continuously and to observe these three O2 pressure simultaneously. Operations were performed endotracheal anesthesia under inhalation of ethrane with maintaining systolic blood pressure 120 mmHg. Setting the rate of O2 and N2O gas inhalation 1/3, PaO2 revealed about 110 mmHg which is similar value as physiological state--1 ATM, air inhalation--. The value of TuO2 and BrO2 were revealed 15.3 +/- 2.3 (mean +/- SE) mmHg and 59.8 +/- 6.5 (mean +/- SE) mmHg. According to these results, it might be said that hypoxic fraction surely exist intratumoral tissue. It is also well known that O2 removes from higher pressure zone to lower pressure zone after O2 was diffused from red blood cell in brain tissue. It might be also mentioned that much lower hypoxic fraction than the value of this study is existing intratumoral tissue. It has long been recognized that hypoxia influences the response of cells and tissues to radiation. However, they have been suspected on the basis of experimental data in vitro. This study showed hypoxic fraction in human brain tumor tissue in vivo.(ABSTRACT TRUNCATED AT 250 WORDS)
Adenocarcinoma↗
[Pneumonectomy in lung cancer in patients over 70 years old--prediction of postpneumonectomy pulmonary function].
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Aged↗
[Prediction of postpneumonectomy pulmonary function using perfusion lung scanning].
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Adult↗
[Computed tomographic evaluation due to ruptured intracranial aneurysms in the posterior fossa].
From April, 1978 through December, 1984, computed tomographic (CT) findings were carefully examined in 34 cases of initial subarachnoid bleeding due to a single ruptured aneurysm in the posterior fossa. All of the patients were hospitalized within 3 days of the onset of symptoms. High-density areas, which indicate the presence of subarachnoid clots, were evaluated in the interhemispheric and Sylvian fissures and the interpeduncular, prepontine, ambient, and quadrigeminal cisterns. The CT data suggest that hematomas in the four cisterns are thicker than those in the supratentorial subarachnoid spaces. Only one patient had an intracerebral hematoma. Hydrocephalus accompanied aneurysms of the posterior fossa more frequently than those of the anterior circulation.
Adult↗
[A case of anaplastic astrocytoma associated with pituitary adenoma].
A case of anaplastic astrocytoma associated with pituitary adenoma is reported. The patient was a 33-year-old male, who was admitted with complaints of sensory aphasia, slight left motor paresis, and visual field defects. Neurological examination disclosed sensory and motor aphasia, Gerstmann's syndrome, slight left motor paresis, right homonymous hemianopsia, and bilateral choked discs. Computed tomography revealed a low density mass lesion with slight enhancement in the left temporal region and a ring-like enhanced mass lesion in the suprasellar region. In MRI, both the left temporal and the suprasellar lesions are depicted as low signal intensity areas in T1 weighted imaging, but as high signal intensity areas in T2 weighted imaging. Craniotomy was performed and both tumors were almost totally removed. The tumor in the left temporal region was diagnosed as anaplastic astrocytoma and the other in the suprasellar region was diagnosed as chromophobe adenoma. Multiple primary intracranial tumors of different cell types are rare. About a hundred cases can be found in medical literature. More than two thirds of them are cases of glioma associated with meningioma, but other combinations of tumors are extremely rare. We now report this case of astrocytoma associated with pituitary adenoma. In the literature, there are only 5 cases of similar combination. It is believed that astrocytoma and pituitary adenoma are histologically different. In three of five reported cases, the tumors were in close proximity to each other, but it is doubtful that their close proximity was related to the fact that they developed concurrently.
Adenoma↗
[Persistent primitive first cervical intersegmental artery (proatlantal artery II) with occlusion of the basilar artery--a case report].
A rare case of persistent primitive first cervical intersegmental artery (proatlantal artery II) is reported. A 58-year-old man was admitted to our hospital with dysarthria and left hemiparesis. On admission he was stuporous with bilateral gaze palsy and left hemiparesis. CT scan on admission showed low density areas in the right cerebellar hemisphere and ventricular part of the pons. Right retrograde brachiography revealed occlusion of the basilar artery, aplasia of the right vertebral artery and an abnormal vessel connecting the right external carotid artery and the right vertebral artery. This anastomotic vessel was thought to be a persistent primitive first cervical intersegmental artery (Proatlantal artery II). Left carotid angiography revealed the left posterior cerebral artery was visualized through the posterior communicating artery, leading from the internal carotid artery. Left retrograde brachial angiography showed that the left vertebral artery terminated just distal from the branching of the left posterior inferior cerebellar artery. After admission the left hemiparesis deteriorated gradually and tracheotomy was done due to respiratory difficulties. The patient was then transferred to the rehabilitation center on his 34th day in hospital with neurological deficits.
Arterial Occlusive Diseases↗
[Revascularization of vertebro-basilar occlusive disease].
Various surgical techniques have been reported for vascular reconstruction in cases of vertebro-basilar occlusive disease, but sufficient study has not been made on the question of which technique should be applied in various pathological conditions. Based on our experience, we have examined the advantages and disadvantages of these techniques. In 34 patients with clinically and angiographically diagnosed vertebro-basilar insufficiency, the reconstructive vascular surgery to the posterior circulation was performed. Preoperatively, 24 had vertebro-basilar TIAs, 2 had RIND, 3 had progressing symptoms and 5 had brain stem infarctions verified by persistent deficits. In the 18 patients with intracranial vertebro-basilar occlusive lesions, the bypass were done to the proximal posterior inferior cerebellar artery in 7 cases, proximal superior cerebellar artery in 9 cases, posterior cerebral artery in one and anterior inferior cerebellar artery in one. In the 16 patients with extracranial occlusive lesions of vertebral artery, endarterectomy or subclavian-vertebral transposition was performed. With the exception of one of the progressing stroke cases, in which the surgery was ultimately too late, there were no cases in which neurological symptoms become aggravated following operation. Patency was 94% (32/34). In light of these findings, the following conclusions concerning the operative indication and the selection of the technique have been drawn. In cases with occlusive lesions of basilar artery, the first choice should be bypass to the proximal superior cerebellar artery. In cases with occlusive lesions of vertebral artery, bypass to the posterior inferior cerebellar or superior cerebellar or anterior inferior cerebellar artery should be performed.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
[Vascular anomalies associated with anterior communicating aneurysms].
Using a bifrontal trans-interhemispheric approach, we have performed direct operations on 206 cases of aneurysm of the anterior communicating artery, 44 of which (21.4%) had vascular anomalies associated with the aneurysm. Those anomalies included 27 cases (13.1%) with median artery of the corpus callosum, 20 cases (9.7%) with duplication of the anterior communicating artery and one case (0.5%) with duplication of the A1 portion. Preoperative diagnosis of the duplications was not possible on the basis of angiograms. Moreover, preoperative diagnosis of the median artery using angiography was unambiguous in only 11 of the 27 cases (41%). The majority (81.5%) of the aneurysms of the anterior communicating artery in cases with a median artery of the corpus callosum were found to develop at the trifurcation of the anterior communicating artery, the A2 portion and the median artery of the corpus callosum.
Cerebral Angiography↗
A portable pneumatic driving unit for a left ventricular assist device.
The authors developed a portable air driving unit for an artificial heart. As the portable energy source of the driver, a commercially available Ni-Cd battery was used. A linear compressor was selected as a portable size compressor. To reduce the number of parts to be assembled, a new type of pneumatic system was employed. In this system, the pressure level was regulated by varying the output flow rate of the compressor instead of using a pressure regulator and large air reservoirs. A one-board microcomputer and pressure sensors were used to control the pressure level. The total weight of the unit is 9.5 Kg. After assembling the components into the portable unit, a blood pump was connected to examine the output characteristics of the system. It was confirmed that the unit could drive the blood pump continuously for more than 2 hours under the following conditions: output flow rate of the blood pump = 5 L/min and output pressure = 100 mmHg.
Assisted Circulation↗
[Twenty-six cases regarding the proximal anterior cerebral artery].
The authors report twenty-six aneurysms of the proximal anterior cerebral artery (A1 segment). Fourteen cases were male and twelve cases were female. Saccular aneurysms were twenty-four and fusiform aneurysms were two. The incidence of the A1 aneurysms was 0.76%. Clinicopathologically, multiplicity of this aneurysm was distinctive, and eleven cases had multiplicity (42.3%). In the seven cases among them, the A1 aneurysms bled (63.6%). These 26 aneurysms were classified into five types according to the mode of the origin of the aneurysm from the A1 segment: (a) fifteen aneurysms originating from the junction of the A1 segment and the small perforating artery, (b) five from the A1 directly, (c) three from the proximal end of the fenestration of the A1, (d) two were fusiform aneurysms, (e) one from the junction of the A1 and the cortical branch. In CT scan of these aneurysms, bleeding extending to the septum pellucidum is very similar to that of the anterior communicating artery aneurysms.
Adult↗
[Transcatheter arterial chemoembolization and selective hepatic arterial infusion using totally implantable reservoir].
Transcatheter arterial chemoembolization (TAE) and hepatic arterial infusion using totally implantable reservoir were performed for the treatment of liver metastasis of colo-rectal cancers, and their therapeutic effects, side effects and complications were evaluated. Eleven cases of H1 (metastasis in one lobe only), 7 cases of H2 (a few scattered metastases in both lobes), 12 cases of H3 (numerous metastases in both lobes) were entered into the study and underwent TAE 45 times. Gel foam, Ivaron and Lipiodol were used as embolic materials in combination with chemotherapeutic agents such as mitomycin C and adriamycin. Serum CEA level was decreased less than 50% of pre-TAE level 20 out of 32 (61%). The tumor size was regressed in 25% of TAE cases which were evaluated on the basis of CT scan. Abdominal symptoms including abdominal pain, nausea and vomiting and fever, leukocytosis, elevated GOT, LDH and bilirubin level were seen after TAE therapy. Median survival of H1, H2 and H3 cases were 21 months, 8 months and 4.5 months, respectively. Another 21 cases (H1, 5 cases: H2, 3 cases: H3, 13 cases) of liver metastasis of colo-rectal cancers were treated with selective hepatic arterial infusion therapy using totally implantable reservoir. Reservoir catheters were implanted into hepatic artery via gastroduodenal artery under direct vision at laparotomy. Mitomycin C, adriamycin and fluorouracil (5-FU) were used as chemotherapeutic agents. No particular side effect such as leukopenia or liver dysfunction was noted. Median survival of H1, H2 and H3 cases treated with arterial infusion were 4 months, 9 months and 9 months, respectively. Median survival of TAE cases and arterial infusion cases was 10 and 6 months, respectively. Thus, the survival rate of cases treated with TAE was better than that of cases treated with arterial infusion.
Antineoplastic Combined Chemotherapy Protocols↗
Recent advances in thromboresistant materials.
There are strong demands for innovative antithrombogenic materials, because of their necessity in fabricating artificial organs and progressive surgical prostheses. This paper reviews the recent advances in thromboresistant materials. Special emphasis is placed on the novel feature of the surface characterization of thromboresistant materials by X-ray photoelectron spectroscopy and its biomedical implications. Essential role of crystalline-amorphous microstructured surface in thromboresistant property of semicrystalline segmented copolymer is also discussed in detail.
Biocompatible Materials↗
The involvement of neuropeptide Y in the antimuricide action of noradrenaline injected into the medial amygdala of olfactory bulbectomized rats.
The present study was designed to clarify the functional role of neuropeptide Y (NPY) in the regulation of muricide induced by olfactory bulbectomy (OB) in relation to that of noradrenaline (NA) in the medial amygdala (AME). NA injected into AME inhibited muricide dose-dependently in OB rats. NPY at doses of 5 and 10 micrograms/microliter injected alone into AME failed to suppress muricide. When NPY 10 micrograms was injected into AME in combination with the maximal non-effective dose of NA, which was determined in each rat, muricide was suppressed in 80% of OB rats. The present study has provided the first evidence suggesting that NPY may be involved in the regulation of OB-induced muricide.
Aggression↗
Changes of brain monoamine contents in three models of experimentally induced muricide in rats.
Monoamine levels were measured by high performance liquid chromatography with electrochemical detection in seven brain regions of three models of experimentally-induced muricide (mouse-killing behavior) in rats (bilateral olfactory bulbectomized rats: OB rats, midbrain raphe nuclei lesioned rats: Raphe rats and nucleus accumbens lesioned rats: Acc rats). Noradrenaline (NA) levels in the lateral hypothalamus (LH) and ventromedial hypothalamus (VMH), 3,4-dihydroxyphenylacetic acid (DOPAC) levels in LH and homovanillic acid (HVA) levels in the frontal cortex (FC) were increased in all three muricide models. In LH, serotonin (5-HT) levels increased in Acc rats and the 5-hydroxyindoleacetic acid (5-HIAA)/5-HT ratio was reduced in OB rats. But in VMH an increase in NA level was not accompanied by any changes of other amines in three muricide models except for 5-HT and 5-HIAA in Raphe rats. In the mamillary body (MB), NA level was increased and 5-HIAA/5-HT ratio was decreased in both OB and Acc rats. Monoamine changes in the amygdaloid nuclei were different in three muricide models, suggesting that the role of monoamines in various nuclei of the amygdala may be different in each muricide model. The present findings suggest that both noradrenergic (LH and VMH) and serotonergic function (LH and MB) may play an important role in exhibiting muricide of OB, Raphe and Acc rats, while dopaminergic function (LH and FC) may be related rather to hyperirritability elicited in these three muricide models.
3,4-Dihydroxyphenylacetic Acid↗
The feasibility of beat-to-beat detection of His-Purkinje activity by finite element method.
A noninvasive method has been applied on human and canine subjects to observe beat-to-beat activity of the His-Purkinje system without using signal averaging. Recordings were performed with multiple Ag/AgCl electrodes, very low noise, high gain amplifiers and by analog filtering. The subjects were in a supine position during the recording. In order to reduce random noise inherent in the high-gain body surface recording, a finite element method (FEM) was applied to calculate His-Purkinje activity. The dimensional relationship between electrode sites, necessary for the calculation, was pre-estimated by x-ray computed tomographs of the subject. A prominent waveform was observed between the atrial and ventricular complexes and corresponded to His bundle activity which was simultaneously recorded by an intracardiac electrode (on every beat). It was, however, difficult to recognize the His-Purkinje activity during inhalation due to the thoracic electromyogram on some human subjects. This interference could theoretically be reduced by increasing the number of body surface electrodes used for this technique.
Animals↗