Drug-induced liver disease during continuous epidural block with bupivacaine.
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Aged↗
Biomedical subjects
Y Toda
Publications and source records attributed to Y Toda.
Complete heart block during anesthetic management in a patient with mucopolysaccharidosis type VII.
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Anesthesia↗
Significance of adrenomedullin under cardiopulmonary bypass in children during surgery for congenital heart disease.
To elucidate the effect of adrenomedullin (AM) on fluid homeostasis under cardiopulmonary bypass (CPB), we investigated the serial changes in plasma AM and other parameters related to fluid homeostasis in 13 children (average age, 28.2 months) with congenital heart disease during cardiac surgery under CPB. Arterial blood and urine samples were collected just after initiation of anesthesia, just before commencement of CPB, 10 min before the end of CPB, 60 min after CPB, and 24 h after operation. Plasma AM levels increased significantly 10 min before the end of CPB and decreased 24 h after operation. Urine volume increased transiently during CPB, which paralleled changes in AM. Simple regression analysis showed that plasma AM level correlated significantly with urinary vasopressin, urine volume, urinary sodium excretion, and plasma osmolarity. Stepwise regression analysis indicated that urine volume was the most significant determinant of plasma AM levels. Percent rise in AM during CPB relative to control period correlated with that of plasma brain natriuretic peptide (r = 0.57, P < 0.01). Our results suggest that AM plays an important role in fluid homeostasis under CPB in cooperation with other hormones involved in fluid homeostasis.
Adrenomedullin↗
Possible participation of isolated epicardial cell clusters in the formation of chick embryonic epicardium.
The embryonic epicardium is formed by the spreading of cells derived from the extracardiac proepicardial organ over the myocardial surface after transfer to the dorsal side of the myocardium via a bridge of villous projections. Using whole-heart immunostaining for keratin, we found that the chronology and pattern of epicardial formation in the chick was basically identical to that reported previously in the quail. However, discrete epicardial islands were observed on the ventrolateral surface of the atrioventricular canal as well as in two previously reported areas. Closer examination by scanning electron microscopy demonstrated the presence of isolated, sparsely distributed epicardial cell clusters on both the dorsal and ventral surfaces of the myocardium. These cells showed a surface morphology similar to that of the epicardial cells at the advancing edge of the spreading epicardial sheet and possessed numerous well-developed filopodia, suggesting active motility. These clusters are probably seeded onto the myocardium by vesicular transport from proepicardial villi, and our findings suggest that the resulting small, localised patches of epicardial cells might accelerate, supplement and tune the epicardial formation mediated by radial spreading of the epicardial sheet in the chick embryonic heart.
Animals↗
Intraarterial corticosteroid infusion following radiotherapy for primary central nervous system lymphoma: feasibility and preliminary result.
To utilize the high lympholytic effect of corticosteroids with minimal systemic adverse effects, we used intraarterial corticosteroid infusion in the treatment of 8 patients with primary central nervous system lymphoma (PCNSL). One patient had recurrent PCNSL, while the other patients had primary disease. Following standard radiotherapy with or without some systemic or intrathecal chemotherapy, prednisolone (60-100 mg in total) or dexamethazone (12 mg in total) was rapidly infused through the carotid arteries in all patients and also through the left vertebral artery in 5 patients. No acute or late complications of this treatment were observed. All 8 patients achieved complete or partial response. Four patients died of the disease, while the other 4 were alive with (1 patient) or without (3 patients) disease at 8-37 months after treatment, giving a 2-year survival rate of 55%. Intraarterial administration of high-dose corticosteroids appears to be a feasible treatment modality. This method may be used in preradiotherapy setting to evaluate response of PCNSL in future studies.
Adrenal Cortex Hormones↗
Liver-type arginase is a highly sensitive marker for hepatocellular damage in rats.
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Animals↗
[The clinical evaluation of the lateral wedged insole fixed elastically on the subtalar joint of patients with osteoarthritis of the knee].
We assessed the clinical efficacy of a lateral wedged insole with elastic fixation of the subtalar joint for conservative treatment of osteoarthritis of the knee. Novel insoles with elastic subtalar fixation (fixed insole) and a traditional shoe insert wedged insoles (inserted insole) were prepared. Seventy-one new female outpatients with osteoarthritis of the knee (knee OA) were treated with wedged insoles for 3 months. Randomization was performed according to birth date. The Severity Index of Lequesne, et al at the final assessment was compared with that at baseline in both the inserted and fixed insole groups. There were 37 participants in the inserted group and 34 participants in the fixed insole group. Regarding discomfort during nocturnal bed rest, 21 out of 34 (61%) participants were positive at the baseline assessment, however, only 8 out of 34 (27%) were positive at the final assessment in the fixed insole group (P = 0.033). In the fixed insole group, the number of participants complained immediate pain after walking was decreased from 28 (82%) at the baseline assessment to 17 (50%) at the final assessments (P = 0.0104). These significant differences were not found in the group with the inserted insole. Thus, clinical efficacy of lateral wedged insole may be emphasized with elastic fixation of the subtalar joint.
Aged↗
Effect of a novel insole on the subtalar joint of patients with medial compartment osteoarthritis of the knee.
OBJECTIVE: To assess the efficacy of a lateral wedge insole with elastic strapping of the subtalar joint for conservative treatment of osteoarthritis (OA) of the knee. METHODS: The efficacy of a novel insole with elastic subtalar strapping and a traditional shoe insert wedge insole was compared. Ninety female outpatients with OA of the knee were treated with wedge insoles for 8 weeks. Randomization was performed according to birth date. Standing radiographs with unilateral insole use were used to analyze the femorotibial and talar tilt angles for each patient with and without their respective insole. Visual analog scale (VAS) score for subjective knee pain at the final assessment was compared with that at baseline in both groups. RESULTS: Participants wearing the elastically strapped insole (n = 46) had significantly decreased femorotibial angle (p < 0.0001) and talar tilt angle (p = 0.005) and significantly improved VAS pain score (p = 0.045) in comparison with baseline assessments. These significant differences were not found in the group with the inserted insole (n = 44). CONCLUSION: The novel strapped insole leads to valgus angulation of the talus, resulting in correction of the femorotibial angle in patients with knee OA with varus deformity, and may have a therapeutic effect similar to that of high tibial osteotomy.
Aged↗
Lean body mass and body fat distribution in participants with chronic low back pain.
BACKGROUND: Loss of muscle mass and central obesity progress with aging, but the effect of muscle loss on chronic low back pain has not been precisely evaluated. METHODS: Three hundred thirty Japanese persons aged 45 to 69 years, with a complaint of low back pain for longer than 3 months (n = 203) and age- and sex-matched healthy control subjects (n = 127), were enrolled in this study. Participants with chronic low back pain were classified into the following groups: (1) women with a positive straight leg raise test result, (2) women with a negative straight leg raise test result, (3) men with a positive straight leg raise test result, and (4) men with a negative straight leg raise test result. Controls were classified by sex into a female and a male group. Anthropometric data, consisting of body mass index, percentage body fat, waist-hip ratio, and lean body mass of the upper extremities, trunk, and lower extremities divided by body weight, were measured in participants with low back pain, and the results were compared with those of controls. RESULTS: The waist-hip ratio in women with a negative straight leg raise test result was significantly higher than those in the female control group (P<.001) and in the women with a positive straight leg raise test result (P =.04). The lean body mass of the trunk and lower extremities divided by body weight of women with a negative straight leg raise test result was significantly lower than that of female controls (P =.03 for the trunk and P<.001 for the lower extremities). However, no significant differences were detected between the female negative straight leg raise test result group and the female control group for lean body mass of the upper extremities divided by body weight or body mass index. There were no significant differences in anthropometric data between the male test and control groups or between the female positive straight leg raise test result group and the female control group. CONCLUSION: Trunk and lower extremity loss of muscle mass and central obesity may be risk factors for chronic low back pain without a positive straight leg raise test result in women aged 45 to 69 years. Arch Intern Med. 2000;160:3265-3269.
Adipose Tissue↗
Constitutive activation of LIL-Stat in adult T-cell leukemia cells.
The activation status of a recently identified STAT (signal transducers and activators of transcription) factor, LIL-Stat (lipopolysaccharide [LPS]/IL-1-inducible Stat) in adult T-cell leukemia (ATL) cells was investigated by electrophoretic mobility shift assays using nuclear extracts of leukemic cells from 7 patients with ATL and a GAS (gamma interferon activation site)-like element termed LILRE (LPS/IL-1-responsive element), which is found in the human prointerleukin 1beta (IL1B) gene. Spontaneous DNA binding of LIL-Stat was observed in all ATL cells examined. However, in normal human peripheral lymphocytes, DNA binding of LIL-Stat was detected only after stimulation with IL-1. These results demonstrated that LIL-Stat is constitutively activated in ATL cells. Furthermore, our transient transfection studies using LILRE chloramphenicol acetyltransferase (CAT) reporters argue that LIL-Stat in ATL cells functions as a transcriptional activator through binding to the LILRE in the IL1B gene. (Blood. 2000;95:2715-2718)
Acute Disease↗
Characteristic sequence pattern in the 5- to 20-bp upstream region of primate Alu elements.
We conducted comprehensive sequence analysis of 5' flanking regions of primate Alu elements. Information contents were computed and frequencies of 1024 pentanucleotides were measured to approximate the location of a characteristic sequence and to specify its pattern(s), which may be involved in the integration of Alu elements into their host genomes. A large number of samples was used, the wide region of the 5' end of Alu elements was analyzed, and comparisons were made among different subfamilies. Through our analyses, "TTTTAAAAA" or "(T)(m)(A)(n)" can be stated as a candidate for the characteristic sequence pattern, which resides around the region 5 to 20 base pairs upstream of the 5' end of Alu elements. This characteristic sequence pattern was more prominent in the sequences of younger Alus, which is a strong indication that the sequence pattern has a role at the time of Alu integration.
Alu Elements↗
Spectrum of color gene deletions and phenotype in patients with blue cone monochromacy.
Blue cone monochromacy (BCM) is an X-linked ocular disease characterized by poor visual acuity, nystagmus, and photodysphoria in males with severely reduced color discrimination. Deletions, rearrangements and point mutations in the red and green pigment genes have been implicated in causing BCM. We assessed the spectrum of genetic alterations in ten families with BCM by Southern blot, polymerase chain reaction, and sequencing analysis, and the phenotype was characterized by ophthalmoscopy, fluorescein angiography, and a battery of tests to assess color vision in addition to routine ophthalmological examination. All families showed clinical features associated with BCM. Acuities were reduced in all affected males, and photopic b-wave was reduced by more than 90% in seven families. In three families, however, the photopic b-wave response showed uncharacteristic relative preservation of 30-80% (of the clinical low-normal value). The color vision was unusually preserved in two affected males, but this was not correlated with photopic electroretinography retention. Progressive macular atrophy was observed in affected members of two BCM families while the rest of the families presented with normal fundus. In nine families deletions were identified in the gene encoding the red-sensitive photopigment and/or in the region up to 17.8 kb upstream of the red gene which contains the locus control region and other regulatory sequences. In the same nine families the red pigment gene showed a range of deletions from the loss of a single exon to loss of the complete red gene. In one family no mutation was found in the exons of the red gene or the locus control region but showed loss of the complete green gene. No association was observed between the phenotypes and genotypes in these families.
Adult↗
Intranasal sensitization of Japanese cedar pollen by the co-administration of low doses of cholera toxin but not its recombinant B subunit to mice.
We evaluated the effects of cholera toxin (CT) and the B subunit of cholera toxin (CTB) on the intranasal sensitization of Japanese cedar pollen (JCP) in mice. JCP suspended in phosphate-buffered saline was administered into the nostrils of mice in combination with varying doses of CT or recombinant CTB(r-CTB) once a week for 5 weeks. Antibody responses specific to sugi basic protein (SBP) were monitored by ELISA for seven weeks. The sensitization of JCP alone did not induce IgG1, IgG2b, IgG2a, IgE or IgA. In contrast, sensitization of JCP in combination with CT (JCP/CT) elicited the prominent production of SBP-specific IgG1 and low levels of IgG2b and IgG2a on Day 49. IgE production was detected only in the serum of mice which were treated with JCP/CT, and not under any other protocol. Using spleen cells from these mice, cytokine production was examined by ELISA in culture supernatants after they had been stimulated in vitro with major cedar pollen allergens, Cry j 1, Cry j 2 or SBP. Notable responses were an increase of IFN-gamma as well as IL-4 in JCP/CT-sensitized cells stimulated with Cry j 2, but not in those stimulated with Cry j 1. No significant differences were detected in IL-5 production among the experimental groups. Histopathological examination, however, showed that eosinophil infiltration was evident in the nasal mucosa of the JCP/CT-sensitized mice following challenge with JCP/CT, but weak with BSA/CT or CT alone. Thus, the immunological and histological analyses indicated that the co-administration of a low dose of CT in combination with JCP allows the induction of pollen-allergic states in mice.
Adjuvants, Immunologic↗
The usefulness of walking for preventing sarcopenia in dieting postmenopausal women complaining of knee pain.
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Aged↗
Observation of the abluminal surface of the atrioventricular endothelium which undergoes transition into cardiac cushion mesenchymal cells in the chick embryo.
In the developing chick heart, endothelial cells in the atrioventricular canal (AV) undergo a series of morphological changes and transform into cushion mesenchymal cells. In the present scanning electron microscopic study, we examined the abluminal surface features of the AV endothelium through an artificial window in the myocardial wall. The AV endothelial cell at stages 12 or earlier had a smooth, flattened basal surface with only a few blebs. In the successive stages, the abluminal surface exhibited remarkable changes; 1) the number of blebs increased, 2) elongated microvillous projections emerged, and 3) a thick filopodium, or a migratory appendage developed. It appeared, however, that these changes do not occur synchronously within the entire AV endothelium but were initially observed mostly in the proximity of the endothelial "crease" which was a limited invagination of the endothelial sheet towards the underlying acellular matrix. In addition, even in the proximity of the crease, endothelial cells with flattened basal surfaces were also observed next to endothelial cells that showed apparent morphological indications of transition into mesenchymal cells. These findings suggest that AV endothelial cells are possibly heterogeneous in the competency of transformation into mesenchymal cells and such heterogeneity would be important for maintaining the continuity of the AV endothelium.
Animals↗
A decline in lower extremity lean body mass per body weight is characteristic of women with early phase osteoarthritis of the knee.
OBJECTIVE: Sarcopenia progresses with aging, but the effect of muscle loss on degenerative joint disorders has not been precisely evaluated. We assessed the distribution of lean body mass (LBM) in middle aged women who had osteoarthritis (OA) of the knee for < 5 years. METHODS: Two hundred thirty-five Japanese women aged 45-69 years, including 117 with knee OA for < 5 years, and 118 age and sex matched healthy controls were studied. Body composition measurements were carried out by segmental bioelectrical impedance using 8 surface electrodes. Anthropometric data consisting of LBM of upper extremities/body weight (U-LBM/W), LBM of trunk/body weight (T-LBM/W), and LBM of lower extremities/body weight (L-LBM/W) for knee OA participants were compared to corresponding data for controls. In the knee OA group, the significance of correlations between anthropometric data and Lequesne index of severity for knee OA and between anthropometric data and disease duration were assessed. RESULTS: L-LBM/W was significantly lower in knee OA participants compared with controls (19.2 +/- 2.7% vs 21.0 +/- 2.9%; p < 0.0001). However, no significant differences in U-LBM/W and T-LBM/W were observed between the knee OA and control groups (p > 0.2). L-LBM/W did not correlate significantly with the index of severity or disease duration (p > 0.2). CONCLUSION: Decline in L-LBM/W, but not U-LBM/W or T-LBM/W, may be important in the pathogenesis of knee OA.
Adipose Tissue↗
[New trends in neoadjuvant chemoradiotherapy for locally-advanced esophageal cancer: esophagectomy--is it necessary?].
In responders to neoadjuvant chemoradiotherapy for locally-advanced esophageal cancer, there was no significant difference in the long-term outcome between patients who underwent esophagectomy and those who did not. Esophagectomy might be unnecessary for patients who achieve a complete response with chemoradiotherapy for an esophageal cancer, in cases when salvage surgery is considered in order to treat any future recurrence.
Carcinoma, Squamous Cell↗
[Four cases of the anomalous origin of the left coronary artery from the pulmonary artery].
We report perioperative management of 4 patients with anomalous origin of the left coronary artery from the pulmonary artery. This report involves with 3 infant cases and an adult. Two infants underwent coronary reimplantation procedure and Takeuchi's method was performed on the other infant. In all infant cases, mitral valve plasty was performed to correct mitral regurgitation secondary to papillary muscle dysfunction. The adult patient underwent CABG with ligation of LCA. General anesthesia was performed with high doses of fentanyl in all cases. We employed a relatively high PaCO2 and low FIO2 in order to maintain a high pulmonary vascular resistance. It aims to decrease the incidence of left to right shunt. We used epinephrine to wean one infant and the adult from cardiopulmonary bypass. Perioperative course was uneventful with the use of catecholamines and high doses of vasodilators for left ventricular dysfunction and coronary perfusion under mechanical ventilation.
Anesthesia, General↗