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Biomedical subjects

E Aoki

Publications and source records attributed to E Aoki.

At least 37 records · Page 2Linked to original sources
PubMed1996

Spontaneous hemopneumothorax.

BACKGROUND: Spontaneous hemopneumothorax is a rare disorder, occurring in 1% to 12% of patients with spontaneous pneumothorax. We studied our previously treated patients to determine the nature of optimal operative management. METHODS: This was a retrospective case study. From 1987 to 1994, of 428 cases of spontaneous pneumothorax that occurred in 234 patients treated at our institution, hemopneumothorax developed in 10 patients (2.3%). The clinical features of these patients were studied. RESULTS: The amount of bleeding ranged from 600 to 1,600 mL, and 3 patients exhibited symptoms of shock, such as sweating, nausea, and syncope. Six patients underwent operation within 7 days from the onset, and this involved resection of the bullae or pneumorrhaphy, or both. The source of bleeding was identified in 5 patients. Pathologic examination showed marked fibrosis with alcian blue-positive deposits of aberrant vessels. All 6 patients continue to be well postoperatively without recurrence or complications. Four patients did not undergo early thoracotomy. However, decortication was required in 3 of these patients because of a reactive fluid collection in the pleural space, which led to impaired lung expansion. CONCLUSIONS: Early surgical repair should be considered once diagnosis of a spontaneous hemopneumothorax is confirmed, because this provides better long-term results. Video-assisted thoracoscopic surgery as well as minithoracotomy should be considered as surgical options because of the improved quality of life they confer.

Adolescent↗
PubMed1996

Mycotic aneurysm of the internal iliac artery caused by Klebsiella pneumoniae.

Mycotic aneurysms are rarely caused by Klebsiella species. We describe a male patient with diabetes mellitus and alcoholism who developed a mycotic aneurysm of the right internal iliac artery complicated by the formation of a false aneurysm. Klebsiella pneumoniae was cultured from arterial blood. An extra-anatomic bypass (left external iliac artery to right common femoral artery) was performed with a successful excision of the aneurysm.

Aneurysm, Infected↗
PubMed1995

Axonal swellings in cerebellar white matter of groggy mutant rat.

In the groggy mutant rat, a number of axonal swellings appeared in the cerebellar white matter from 180 days of age onward. Since these axonal swellings were immunostained with an antibody against calbindin D28k, the axons forming these swellings were considered to belong to Purkinje cells. They were also immunostained with an anti-neurofilament antibody, and ultrastructurally characterized by the presence of myelin sheaths around them and abnormal accumulations of filamentous structures, mitochondria and smooth endoplasmic reticula (SER) in their axoplasm. The SER were considered to convey acid phosphatase (ACPase) to the swelling's axoplasm, where ACPase was set free from the SER throughout the axoplasm and engaged in the digestion of cytoplasmic organelles. The groggy rat is useful model model for the study of the mechanism of the age-related formation of axonal swellings.

Age Factors↗
PubMed1995

Concentric lamellar bodies in axon terminals and preterminal axons of cerebellar Purkinje cells in groggy mutant rat: acid phosphatase cytochemistry.

The process of formation and degeneration of concentric lamellar bodies (CLBs) in axon terminals and preterminal axons of Purkinje cells were examined by acid phosphatase (ACPase) cytochemistry. In myelinated axons, tubular structures measuring 20-50 nm in diameter contained ACPase reaction products. In altered axon terminals and preterminal axons of Purkinje cells, elongated saccular structures contained numerous reaction products. These saccular structures were arranged concentrically and enclosed cytoplasmic organelles. In the CLBs displaying degenerative profiles, ACPase reaction products were dispersed in the degenerating materials. The nature of the tubular structures and their roles in the transport of ACPase and the formation of CLBs are discussed.

Acid Phosphatase↗
PubMed1995

[Thoracoscopic treatment of a giant bulla: a case report].

A 38-year-old man was admitted to our hospital because of left giant bulla and pneumothorax. His chest X-rays and CT scan showed giant bulla of the left upper lobe and left pneumothorax. We performed bullectomy using the ENDOPATH ENDO LINEAR CUTTER 60 mm and 35 mm disporsable surgical stapler under thoracoscopic guidance. Clipping with end-clips and fibrin glue were effective for miner air leakage. There were no complications such as prolonged air leakage or incomplete lung re-expansion. His post operative couse was uneventful and he was discharged from the hospital on the 11th post operative day. When performed along with mini-thoracotomy, thoracoscopic operation is useful in treating patients with giant bulla.

Adult↗
PubMed1995

[Assessment of 201Tl myocardial SPECT reinjected at 24 hours after stress imaging].

To improve the quality of 24 hours delayed images (24 DL) of stress thallium-201 myocardial SPECT, reinjection was performed at 24 hours later (24 RI), and the results were compared with those of 24 DL. A total of 45 patients were studied, including 18 patients in 24 DL, 27 patients in 24 RI. All of them showed persistent defect or incomplete redistribution on the routine stress and 3 hours delayed SPECT scans. In 24 RI, 37 MBq of thallium-201 was reinjected at 24 hours later. Myocardial count of 24 DL was about 1/4 of stress image, while 24 RI was about 1/2. Quality of 24 RI image was nearly equal to 3 hours delayed image. Of regions without redistribution at 3 hours delayed image, 5 (36%) regions showed new redistribution at 24 RI. Of regions incomplete redistribution, 6 (25%) regions showed further redistribution. Compared with 24 DL, the frequency of redistribution tended to be higher in this protocol than that of the 24 DL (11%, 17% respectively). In conclusion, the reinjection at 24 hours delayed imaging was considered to be useful to evaluate viability of myocardium in patient with CAD.

Aged↗
PubMed1995

[Value of stress-rest ECG gated SPECT one day protocol using 99mTc-MIBI].

A total of 110 patients suspected with CAD who had symptoms or ECG abnormalities were enrolled in the stress-rest ECG gated SPECT one day protocol using 99mTc-MIBI. All the patients underwent symptom-limited exercise testing and 250 MBq of MIBI was injected at peak exercise. Exercise perfusion SPECT images were reviewed by two trained doctors to classify into three groups; normal, equivocal and abnormal. Patients with normal stress image (n = 53) did not receive the resting study. On the other hand, those with equivocal (n = 20) and abnormal (n = 37) stress images performed resting study, including gated SPECT. Of 20 equivocal cases, 16 patients showed unchanged resting perfusion. All of these had normal wall motion. The remaining 4 patients showed improved resting perfusion, indicating presence of myocardial ischemia. Of 37 abnormal cases, 12 patients showed improved resting perfusion, whereas 25 patients showed unchanged resting perfusion. Cardiac events were more often observed in abnormal cases, especially those associated with myocardial ischemia, while good prognosis was obtained in normal cases. Values of this protocol are (1) Patients with normal stress images need no resting study. (2) All the procedure can be completed in one day. (3) Both cardiac function and perfusion can be obtained with gated SPECT. These data indicates that this protocol is valuable for screening patients suspected with CAD.

Coronary Circulation↗
PubMed1994

Age-related and region-specific increase in number of concentric lamellar bodies in axon terminals and presynaptic axons in central nervous system of groggy mutant rat.

In some regions of the central nervous system (CNS) of the groggy rat, a mutant with a movement disorder, concentric lamellar bodies (CLBs) were formed in numerous axon terminals and presynaptic axons. These bodies were counted electron microscopically in the lateral cerebellar nuclei of Slc:Wistar and groggy mutant rats at 20 to 180 days of age. In the Slc:Wistar rat groups, the mean numbers of axonal CLBs were mostly under 1.0 per 100 microns2, except for the 30-day-old rat group which showed a value of 1.7. In the groggy rat groups, the numbers of axonal CLBs greatly increased from 40 days of age onward, reaching the maximum mean number of 23.7 per 100 microns2 in the 90-day-old rat group and subsequently decreasing; however, significant numbers were still present in the 180-day-old rat group. Since these bodies have been reported to contain an acid phosphatase (ACPase), the regional specificity of their appearance in the CNS was examined by light and electron microscopic ACPase histochemistry. In the 90- and 180-day-old groggy rats, numerous particulate deposits of ACPase reaction products were found in the neuropil of the lateral, interposed and medial cerebellar nuclei, the superior, lateral and spinal vestibular nuclei, and the spinal gracile nuclei. By electron microscopy, the particulate deposits in the cerebellar and vestibular nuclei were confirmed as the CLBs in axon terminals, while those in the gracile nuclei were revealed to be the dystrophic axons. Thus, it was suggested that the axon terminals and presynaptic axons, having a high capacity to form the CLBs in the groggy rats from 40 days of age onward, belong to the Purkinje cells.

Acid Phosphatase↗
PubMed1994

The successful surgical repair of a traumatic transection of the descending thoracic aorta: report of a case.

An 18-year-old man involved in a traffic accident presented with a left-sided hemothorax. After undergoing left chest tube drainage, he showed temporary stable hemodynamics for 7 h. Later, an emergency left thoracotomy was performed because of abrupt hemorrhagic shock. The intima and media of the descending thoracic aorta was completely transected, and a tube graft was successfully interposed with a simple aortic clamp in 47 min. The patient was eventually discharged from the hospital with no sequelae, such as paraplegia.

Accidents, Traffic↗
PubMed1994

An immunohistochemical study of aspartate, glutamate, and taurine in rat kidney.

Biochemical studies have revealed considerable amounts of free amino acids in the kidney. We examined the intrarenal distribution of three amino acids (aspartate, glutamate, and taurine) in the rat kidney with an immunoperoxidase method. In the renal cortex, all three amino acids were concentrated in the renal corpuscles and in the epithelia of the collecting tubules. Immunostaining of the collecting tubules was more intense in the principal cells than in the intercalated cells. The distal convoluted tubules were also immunostained with aspartate- and glutamate- specific antibodies but not with the taurine-specific antibody. In the renal medulla, the immunoreactivity specific for aspartate and for glutamate was similar; it was weak in the thick portion of the loop of Henle and strong in the collecting tubules. Immunoreactivity specific for taurine was restricted to regions within the epithelia of the thin portion of the loop of Henle and the collecting tubules. The significance of the accumulated amino acids as osmoregulatory agents is discussed.

Animals↗
PubMed1994

[Assessment of left ventricular count increase with ECG-gated 99mTc-MIBI SPECT using a single-head rotating gamma-camera].

ECG-gated 99mTc-MIBI SPECT was performed in 33 patients, including 17 normal subjects and 16 patients with old myocardial infarction. To compare the findings by echocardiography (UCG), regional wall motion was qualitatively assessed by cine-mode display and quantitatively measured as an increase in regional count from end-diastole to end-systole. The percent count increase and relative count increase was measured to display on the Bull's eye polar map. In the study of normal subjects, the count increase was greater in apical regions and smaller in septal regions. Regional wall motion by this method correlated well with UCG findings (agreement: 97%, complete agreement: 60%). A mild but significant correlation was observed between the count increase by this method and the percent wall thickening by UCG. We conclude that regional wall motion can be accurately evaluated with ECG-gated 99mTc-MIBI SPECT, which thus permits simultaneous assessment of regional wall motion and myocardial perfusion.

Aged↗
PubMed1994

Electron microscopic cytochemistry of acid phosphatase activity in dystrophic axons of rat gracile nuclei.

Dystrophic axons (DAs) in rat gracile nuclei were largely classified into two types. One type had a focal swelling measuring about 2-8 microns in diameter, and contained greatly increased numbers of various cellular organelles. Numerous reaction products of acid phosphatase (ACPase) cytochemistry were deposited in the cytoplasmic matrix and the multilaminated bodies. The second type ranged from 8 microns to 50 microns in diameter, and was characterized by the presence of a large number of fine tubular structures in the cytoplasm. Only a few reaction products of ACPase cytochemistry were localized in the small vesicular structures. The functional role of ACPase in the degradation and accumulation of cellular organelles in DAs is discussed.

Acid Phosphatase↗
PubMed1993

Localization of nitric oxide-related substances in the peripheral nervous tissues.

Nitric oxide (NO) is now recognized as a transduction molecule in many biological systems, and is known to promote the synthesis of cGMP by activating the soluble guanylate cyclase. NO synthase which fully accounts for all the neuronal activity of NADPH diaphorase catalyzes L-arginine to NO and L-citrulline. In the present study, the localization of NO-related substances, L-arginine, NO synthase, L-citrulline and cGMP in the enteric plexus and dorsal root ganglia was demonstrated with immuno- or enzyme-histochemical methods. L-Arginine was proved accumulated in glial cells, while NO synthase and L-citrulline were found in neurons. Cyclic GMP was predominantly observed in glial cells. These results reveal L-arginine-NO-cGMP pathway may be present in the enteric plexus and dorsal root ganglion as in the brain, and provide visible evidence that NO mediates neuron-glia communications in this pathway.

Animals↗
PubMed1993

A patient with hepatocellular carcinoma who underwent resection of the primary lesion 10 years ago and resection of a giant adrenal metastasis 8 and a half years later.

A 56-year-old male consulted us because of a palpable mass and pain of the left flank 8 and a half years after resection of hepatocellular carcinoma of the left lobe about 3 cm in diameter. Ultrasound examination of the abdomen demonstrated a tumor about 10 cm in diameter showing a mosaic of hyperechoic and hypoechoic areas on the upper pole of the left kidney. By angiography, the tumor was found to be supplied mainly by the inferior adrenal artery. PIVKA-II was increased. Adrenal metastasis of hepatocellular carcinoma was suspected, and adrenalectomy was carried out. No intrahepatic metastasis was noted. The tumor was histopathologically identified as a pseudo-glandular type of moderately differentiated hepatocellular carcinoma with a trabecular pattern similar to the primary lesion. In this patient, a resectable giant metastasis was observed only in the left adrenal gland and no intrahepatic metastasis was demonstrated 8 and a half years after resection of hepatocellular carcinoma. The patient has survived 10 years after the first operation. This case is considered to be important for evaluation of the treatment for distant metastasis of hepatocellular carcinoma.

Adrenal Gland Neoplasms↗
PubMed1991

Evidence for the presence of L-arginine in the glial components of the peripheral nervous system.

L-Arginine is a precursor of nitric oxide that has been identified as an endogenous activator of soluble guanylate cyclase. We have recently reported the immunocytochemical localization of free L-arginine in glial cells in the central nervous system (CNS) using specific anti-arginine antibody. In the present study, we focused our attention on this particular amino acid in the peripheral nervous system (PNS). In the cochlea of the inner ear, arginine-like immunoreactivity was localized in satellite cells surrounding neurons of the spiral ganglion. In the dorsal root ganglia, satellite cells surrounding sensory neurons were found to be immunoreactive. In the superior cervical ganglion, L-arginine was concentrated in satellite cells around neuronal cells. In ganglia of the enteric plexus, supporting cells that covered neuronal cells were stained. These results show that free L-arginine in the PNS is concentrated in satellite and supporting cells, both of which correspond to glial cells in the CNS. Thus, those cells in ganglia of the PNS may support and/or control the neural activity by providing L-arginine to the neurons that they surround.

Animals↗
PubMed1991

Predominant localization in glial cells of free L-arginine. Immunocytochemical evidence.

Nitric oxide has been recently identified as an endogenous activator of the soluble guanylate cyclase in the brain as well as in vascular endothelial cells and macrophages. In the present study, we determined the localization of free arginine in the brain because nitric oxide was formed from the terminal guanido group of L-arginine. Anti-arginine antiserum was raised in guinea pigs by repeated injection of L-arginine covalently conjugated to guinea pig serum albumin via glutaraldehyde. Specific anti-arginine antibody was purified from the antiserum by using an affinity gel coupled with L-arginine. Arginine-like immunoreactivity in the rat brain and spinal cord was found concentrated mainly in astrocytes including Bergmann glial cells in the cerebellum and processes of astrocytes around blood vessels. The present results suggest that glial cells, particularly astrocytes, are the main locus of L-arginine, a nitric oxide precursor, in the brain.

Animals↗