PubMed Health⌕ Search

Biomedical subjects

H Anai

Publications and source records attributed to H Anai.

At least 19 recordsLinked to original sources
PubMed2002

The mature form of adrenomedullin correlates with brain natriuretic peptide in plasma of chronic hemodialysis patients.

AIM: Adrenomedullin (AM), a hypotensive and natriuretic peptide, consists of an amidated mature form (mAM) and an intermediate form in human plasma, of which only mAM exerts biological activity. Like atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP), plasma levels of mAM are reported to be significantly elevated in hemodialysis (HD) patients, suggesting that mAM may be stimulated partly by increased body fluid volume in a manner similar to the natriuretic peptides. Here, we examined the relationship between mAM levels and ANP or BNP levels and the effect of HD on plasma mAM in HD patients. PATIENTS AND METHODS: We measured plasma levels of mAM, total AM (tAM), ANP and BNP before and after HD in patients on long-term HD (n = 22, mean age 56.3 +/- 3.2 years) using radioimmunoassay. RESULTS: Baseline mAM (2.7 +/- 0.3 fmol/ml) and tAM (23.6 +/- 2.0 fmol/ml) were significantly higher in HD patients than in healthy subjects (1.1 +/- 0.2 fmol/ml, 9.0 +/- 2.1 fmol/ml, respectively). HD significantly reduced the levels to 1.2 +/- 0.2 fmol/ml and 13.8 +/- 1.4 fmol/ml, respectively, although tAM levels were still elevated compared to healthy subjects. Similar plasma ANP and BNP levels were obtained in HD patients. There were significant correlations between mAM and tAM levels before and after HD and between HD-induced changes in mAM and tAM levels. In the pre-HD state, levels of both mAM and tAM correlated significantly with BNP levels, but the correlation of BNP with mAM was closer than that with tAM. In contrast, no correlations were observed between the 2 forms of AM and ANP. Changes in mAM levels during HD also correlated significantly with BNP but not ANP levels, although the changes in tAM did not correlate with those of the 2 natriuretic peptides. CONCLUSION: Our results suggest that the secretion/metabolism of mAM may be regulated in a manner similar to that of BNP in HD patients.

Adrenomedullin↗
PubMed2002

Tuberculous pseudoaneurysm of the ascending aorta associated with intracranial tuberculoma.

A tuberculous aneurysm is rare and fatal because it may lead to a rupture due to the forming of a pseudoaneurysm. A lesion is especially uncommon in the ascending aorta. We report an unusual case of tuberculous pseudoaneurysm of the ascending aorta which developed 7 months after the onset of multiple intracranial tuberculoma in a 59-year-old man. He was treated for multiple intracranial tuberculomas in another hospital because of headache and left homonymous hemianopia. The temporal intracranial tuberculomas were reduced after antituberculous drug administration. However, they enlarged again shortly thereafter. At that time, a pseudoaneurysm of the ascending aorta was found, so he was introduced to our department. Intensive antituberculous drugs were administered perioperatively and postoperatively. The intracranial tuberculoma was reduced preoperatively. After that, the ascending aorta was successfully replaced with a Dacron graft. A hole was noted in the back of the ascending aorta. Three years after the operation, no symptoms of recurrence have been recognized. A tuberculous pseudoaneurysm of the ascending aorta may easily cause systemic tuberculosis or rupture, therefore it should be treated as early as possible.

Aneurysm, False↗
PubMed2002

[Arch translocation method for an arch aneurysm with open stent grafting using a nephrostomy catheter].

An 81-year-old female found to have an aneurysm in the distal aortic arch was successfully treated with arch translocation method. Under selective cerebral perfusion, a stent graft bound to a nephrostomy balloon catheter with a chainstitch was inserted from the ascending aorta into the descending aorta and its proximal end was sutured together with the distal aortic stump. Then a 4-branched Dacron graft replaced the ascending aorta reconstructing cephalobracheal branches individually. Each proximal end of cephalobracheal branches was ligated. The patient had no neurological deficit except for recurrence nerve palsy that had already existed before the operation. Postoperative angiography revealed complete thrombocclusion of the aneurysm.

Aged↗
PubMed2001

Left ventricular free wall rupture possibly induced by coronary spasm. Surgical repair in the emergency room.

A 68-year-old woman complained of chest discomfort after a traffic accident in which she driving hit a child. At about twenty-five minutes later, she went into sudden cardiogenic shock due to acute myocardial infarction caused by non-occlusive intracoronary thrombosis without significant organic coronary stenosis and without any sign of extraluminal contrast pooling on coronary angiography. She was transported to our emergency room by ambulance because of cardiac tamponade caused by a left ventricular free wall rupture following the acute myocardial infarction. On arrival, she was near cardio-pulmonary arrest on intraaortic balloon pumping. We performed emergency open cardiac massage and pericardiotomy. The hairline perforation responsible for the blowout-type left ventricular free wall rupture was successfully closed with Teflon-reinforced sutures. In conclusion, it was strongly suspected that the present case of left ventricular free wall rupture was caused by acute myocardial infarction due to intracoronary thrombosis following coronary spasm without significant organic coronary stenosis or rupture of atheromatous plaque.

Aged↗
PubMed2001

Adenosquamous carcinoma of the sigmoid colon: report of a case.

A case of adenosquamous carcinoma of the sigmoid colon is presented herein. An 85-year-old woman without any symptoms was admitted to our hospital to undergo detailed examinations of the colon and rectum. Colonoscopy showed a huge type 2 tumor in the sigmoid colon. A typical sigmoid colectomy and lymph node dissection were performed. A histopathological investigation demonstrated adenosquamous carcinoma invading the subserosa. Although an absolute curative resection was performed, she died of metastatic lung carcinoma 14 months after the operation.

Aged↗
PubMed2001

Amelanotic malignant melanoma of the rectum: report of a case.

We describe herein a case of amelanotic melanoma of the rectum. Macroscopically, the tumor was lacking in pigmentation and microscopically, it was found to be deficient in melanin. Moreover, the tumor cells showed positive staining for HMB-45, the antimelanoma antibody, which led to a diagnosis of amelanotic melanoma. The patient died of metastatic tumors in the liver and bone 17 months after undergoing abdominoperineal resection of the rectum and dissection of the bilateral inguinal lymph nodes.

Aged↗
PubMed2001

Usefulness of reconstruction with jejunal pouch in total gastrectomy for gastric cancer in early improvement of nutritional condition.

BACKGROUND: Roux-en-Y reconstruction with a jejunal pouch is a modified standard procedure in total gastrectomy for gastric cancer. The aim of the current study was to evaluate the usefulness of the reconstruction using a jejunal pouch in subsequent improvement of the nutritional condition of patients with gastric cancer after total gastrectomy. METHODS: Sixteen patients with gastric cancer treated by total gastrectomy and reconstruction with simple Roux-en-Y from January 1993 to December 1996 and 14 patients treated by total gastrectomy and reconstruction with Roux-en-Y and jejunal pouch from January 1997 to December 1998 were investigated in regard to postoperative heartburn, changes in the body weight, and prognostic nutritional index. RESULTS: Postoperative heartburn occurred in 1 patient (7.1%) among patients treated with Roux-en-Y and jejunal pouch and 3 (18.8%) among patients treated with simple Roux-en-Y. The body weight ratio at 1 year after operation in patients treated with Roux-en-Y and jejunal pouch (88.2% +/- 4.2%) was significantly higher than that in patients treated with simple Roux-en-Y (80.0% +/- 4.6%; P <0.01). The prognostic nutritional index ratios for patients treated with Roux-en-Y and jejunal pouch at 1 and 3 months after operation were 93.9% +/- 9.1% and 101.7% +/- 11.0%, respectively, and were significantly higher than that in patients treated with simple Roux-en-Y (86.2% +/- 8.8% and 88.1% +/- 8.2%, P <0.05 and P <0.01, respectively). CONCLUSIONS: Reconstruction using a jejunal pouch in total gastrectomy is useful for an early improvement of the nutritional condition of patients with gastric cancer.

Aged↗
PubMed2001

Stented elephant trunk method for multiple thoracic aneurysms.

Stent-grafting and open graft replacement was introduced to reduce the complications of suture anastomosis in the descending aorta. We applied this technique in the treatment of a patient with multiple thoracic aneurysms. The elephant trunk procedure was used for thromboexclusion. A single branched graft was placed easily without twisting. In patients with aneurysms at both the proximal and distal thoracic aorta, combined stent-grafting and open graft replacement is an excellent approach.

Aged↗
PubMed2001

Activation of hypothalamic neuronal nitric oxide synthase in lithium-induced diabetes insipidus rats.

The expression of the neuronal nitric oxide synthase (nNOS) gene in the paraventricular (PVN) and supraoptic nuclei (SON) in rats with lithium (Li)-induced polyuria was examined by using in situ hybridization histochemistry. The state of the thyroid axis in these rats was also examined by in situ hybridization histochemistry for thyrotropin-releasing hormone (TRH) and thyroid-stimulating hormone (TSH) mRNAs and radioimmunoassay for circulating thyroid hormones. Adult male Wistar rats consuming a diet that contained LiCl (60 mmol/kg) for 4 weeks developed remarkable polyuria. The urine in the Li-treated rats was hypotonic and had a large volume and low ionic concentration. The nNOS mRNA in the PVN and SON was significantly increased in the Li-treated rats in comparison with that in control. The increased levels of the nNOS mRNA in the PVN and SON were confirmed by NADPH-diaphorase histochemical staining. There were no differences of TRH mRNA in the PVN, TSH mRNA in the anterior pituitary and plasma concentrations of free T3 and free T4 between Li-treated rats and control rats. These results suggest that Li-induced diabetes insipidus may activate nNOS in the PVN and SON without change of the thyroid axis.

Animals↗
PubMed2001

Pressure-induced expression of monocyte chemoattractant protein-1 through activation of MAP kinase.

BACKGROUND: In glomerular hypertension, mesangial cells (MC) are subjected to at least two physical forces: a high pressure and mechanical stretch. In 5/6 nephrectomized rat, a model of progressive glomerular sclerosis associated with glomerular hypertension, monocyte chemoattractant protein-1 (MCP-1) is expressed in glomeruli, suggesting the possible role of MCP-1 in the pathogenesis of glomerular sclerosis; however, whether pressure directly affects MCP-1 expression remains undetermined. Here we examined the effects of pressure on MCP-1 expression in cultured rat MC and the signal transduction pathways that lead to MCP-1 expression. METHODS: Pressure was applied to MC by instilling compressed helium gas into sealed plates. MCP-1 mRNA and protein levels in MC were detected by reverse transcription-polymerase chain reaction (RT-PCR) or Northern blotting and ELISA or Western blotting, respectively. Mitogen-activated protein (MAP) kinase activity was measured with the catalytic activity of p42/p44 MAP kinase and anti-phospho p42/p44 MAP kinase antibody. A transient transfection assay that specifically modulates MAP kinase kinase (MEK) activity was carried out. RESULTS: MCs subjected to external pressure expressed MCP-1 mRNA rapidly and transiently with the peak level noted at 10 minutes and 80 mm Hg pressure. MCP-1 protein levels in cell lysates and culture medium also significantly increased after pressure loading. Pressure rapidly increased the phosphorylation level and activity of p42/p44 MAP kinase. Treatment of MC with a MAP kinase kinase (MEK) inhibitor, PD98059, suppressed levels of both pressure-induced MAP kinase activities and MCP-1 mRNA expression. The constitutively activated type of MEK1 induced MCP-1 expression (13.7-fold) even in non-pressurized MC. CONCLUSIONS: Our results indicate that pressure per se can induce MCP-1 via activation of MAP kinase pathway, suggesting that glomerular hypertension might be involved in the progression of renal diseases through the expression of MCP-1 in MC.

Animals↗
PubMed2001

[A case report of Ebstein's anomaly treated with Hetzer's procedure].

A 27-year-old male who had been diagnosed with Ebstein's anomaly was admitted with uncontrollable congestive heart failure. The echocardiogram revealed severe tricuspid valve incompetence and the electrocardiogram showed atrial fibrillation. He underwent Hetzer's repair procedure for tricuspid valve incompetence and Minzioni's right atrial isolation technique to restore sinus rhythm. His congestive heart failure quickly disappeared and sinus rhythm was restored after operation. He was discharged 3 weeks postoperatively and remains well 22 months after his operation. Hetzer's technique for tricuspid valve repair in Ebstein's anomaly restructures the valve mechanism at the level of the true tricuspid anulus by using the most mobile leaflet for valve closure without plication of the atrialized chamber. We conclude that Hetzer's procedure is an effective operation for Ebstein's anomaly.

Adult↗
PubMed2001

Early and long-term results of cardiovascular surgery in octogenarians.

The purpose of this study was to evaluate characteristics and outcomes of octogenarians undergoing cardiovascular surgery with cardiopulmonary bypass in a Japanese population. Thirty-one consecutive patients over 80 years of age underwent coronary artery bypass grafting 19 (61%), combined coronary artery bypass grafting and ventricular septal perforation closure 1 (3%), valve replacement 3 (10%), and prosthetic graft replacement 8 (26%). The early mortality rate was 16.1%. Survival estimates were 74% after 1 year, 74% after 3 year, and 64% after 5 years. Emergency and urgent cases involved 16 (51.6%), and 2 patients (6.5%), respectively. Multivariate analyses revealed that predictors of early mortality was preoperative left ventricular ejection fraction. Predictors of hospital death (within 3 months after surgery) were preoperative renal dysfunction, intraaortic balloon pumping, and age. Predictors of late mortality were chronic lung disease and age. Twenty-one patients expected to have died before surgery were living at home, and 9 (40.9%) patients were completely autonomous. Multivariate analyses revealed diabetes mellitus and a small number of bypass grafts were predictive risk factors for postoperative autonomy. Thus, cardiovascular surgery can be performed in octogenarians under 85 years of age with a favorable long-term outcome, when appropriately applied in selective octogenarians without significant comorbidity. If patients are over 85 years of age or have significant comorbidity, clinical treatment recommendations should be individually tailored while evaluating the risk of having or not having surgery and their life expectancy. QOL of survivors was almost satisfactory and significantly improved compared with a preoperative state.

Age Factors↗
PubMed2000

Clinicopathological characteristics of mucinous carcinoma of the colon and rectum.

BACKGROUND AND OBJECTIVES: Clinicopathological significance of colorectal mucinous carcinoma (MC) remains controversial. The aim of the current study was to investigate the clinicopathological characteristics of colorectal MC. METHODS: Eighteen patients with MC and 265 with moderately or well differentiated adenocarcinoma of the colon and rectum, were clinicopathologically compared. RESULTS: MCs occurred in the right colon significantly more frequently than did non-mucinous carcinomas (NMCs). The maximal size of the tumors in MCs (7.0 +/- 2.9 cm) was significantly larger than that in NMCs (5.1 +/- 2.1 cm) (P < 0.001). Although the ratio of patients with peritoneal metastasis in MCs (22.2%; 4/18) was significantly higher than that in NMCs (6.0%; 16/265) (P < 0.05), there was no significant difference regarding liver metastasis. The proportion of lymph node metastasis in MCs (72.2%; 13/18) was significantly higher than that in NMCs (44.9%; 119/265) (P < 0.05). There was no significant difference regarding the lymphatic and venous invasion. The 1-, 3-, and 5-year survival rates of patients with MCs were 77. 8%, 45.4%, and 30.3%, respectively, and were significantly lower than those in patients with NMCs, that were 88.9 %, 65.6%, and 60.8%, respectively (P < 0.05). CONCLUSIONS: As colorectal MCs proliferate and metastasize more rapidly than do NMCs, surgeons should realize that more aggressive surgical treatment should be occasionally administered to improve the postoperative prognosis of the patients with colorectal MCs.

Adenocarcinoma, Mucinous↗
PubMed2000

Video-assisted thoracoscopic treatment for spontaneous pneumothorax as two-day surgery.

BACKGROUND: To see whether video-assisted thoracoscopic surgery (VATS) for spontaneous pneumothorax (SP) as 2-day surgery is a safe and cost-effective procedure, we retrospectively compared VATS as 2-day surgery with standard VATS. METHODS: From April 1994 to March 2000, 139 SP patients were operated on: 115 patients were operated on by means of standard VATS and 24 were treated by 2-day surgery. The parameters we compared were the postoperative complications, hospitalization cost, and relapses. RESULTS: Excepting that 2 of those selected for 2-day surgery required another hospitalization, short-term complications were considered to be similar for the two groups. The median economic cost of 2-day surgery was about $5,822 US dollars and was lower than that of standard VATS. The difference in the recurrence rate between the two groups was not significant. CONCLUSIONS: We conclude that VATS as 2-day surgery is a safe and cost-effective procedure.

Adolescent↗
PubMed2000

Sensorless controlling method for a continuous flow left ventricular assist device.

We originated a novel control strategy for a continuous flow left ventricular assist device (LVAD). We examined our method by acute animal experiments to change the left ventricular (LV) contractility or LV end-diastolic pressure (LVEDP). To estimate the pump pulsatility without any specific sensor, we calculated the index of current amplitude (ICA) from motor current waveform. The ICA had a peak point (t-i point) that corresponded closely with the turning point from partial to total assistance, and a trough (s-i point) that corresponded with the beginning point of ventricular collapse. The pump flow at the t-i point (Qt-i) had no component of flow regurgitation. In the evaluation of the effects of preload LVEDP, afterload (mAoP), and contractility (max LV dp/dt), we found that preload was the only parameter that significantly influenced Qt-i. We concluded that our method could well control continuous flow LVAD by preventing reversed flow and ventricular collapse.

Animals↗
PubMed2000

Video-assisted thoracoscopic surgery for bilateral spontaneous pneumothorax in supine position: the use of a pillow beneath the back for intercostal space widening.

We performed a single stage video-assisted thoracoscopic surgery for bilateral spontaneous pneumothorax in the supine position with both arms abduced and the back slightly elevated using a pillow. While intercostal spaces were not open enough to insert a trocar, this procedure, not requiring the trouble of placing patients in the lateral decubitus position, is beneficial for the single treatment of bilateral thoracic discase.

Adult↗
PubMed2000

Prognosis and surgical treatment of gastric cancer invading the pancreas.

The clinicopathologic characteristics of gastric cancer invading the pancreas have not been determined. Gastrectomy was performed in 282 patients with gastric cancer invading adjacent organs at the Department of Surgery II, Kyushu University Hospital, between 1970 and 1987, and patient data were retrospectively analyzed using univariate and multivariate analyses. Of these patients, 150 (53.2%) had tumors invading the pancreas and 132 had tumors invading adjacent organs other than the pancreas. In both groups, the undifferentiated tissue type with infiltrative growth, lymphatic involvement and lymph node metastasis was common. In cases of pancreas invasion, the extent of lymph node metastasis was more severe, vascular involvement was more frequent and the rate of concomitant liver metastasis was higher. The survival time of the patients with pancreas invasion was shorter compared to patients with cancer invading other organs, and pancreas involvement was one of the independent factors predicting a poor prognosis. With respect to surgical treatment of gastric cancer invading the pancreas, the prognosis was better for cases treated with curative surgery and pancreas resection. Of 39 patients treated with partial resection of the pancreas, the tumor had invaded only the capsule of the pancreas in 18 and the pancreas in the other 21. Pancreas-invasive gastric cancer cells are likely to advance via lymphatic and vascular routes and survival time is shorter, but curative resection can improve the survival rate, and perioperative treatment should be appropriately designed.

Aged↗