Biomedical subjects
Publications and source records attributed to J Tanaka.
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We studied metabolic abnormalities of postoperative organ failure in 55 patients and classified them into four groups according to the postoperative changes in the arterial blood-ketone body ratio (acetoacetic acid-beta-hydroxybutyric acid) reflecting hepatic mitochondrial redox potential: patients in group A had no decrease below 0.7, patients in group B had a transient decrease to 0.4, patients in group C had a progressive decrease to below 0.4, and patients in group D (terminal stage) had a decrease to below 0.25. All group A and B patients tolerated their operations well; the group C and D patients had multiple organ failure. In groups B, C, and D, plasma concentrations of alanine, proline, phenylalanine, and tyrosine were negatively correlated with the blood--ketone body ratio and the molar ratios between the plasma concentrations of branched-chain amino acids and aromatic amino acids were positively correlated with the blood--ketone body ratio. Hepatic energy deficit associated with decreasing blood-ketone body ratio may be the metabolic basis of postoperative organ failure.
Plating efficiency (PE), i.e. colony forming ability, of primary human embryonic lung fibroblasts persistently infected with baboon endogenous virus (BaEV) decreased to less than 10 per cent of that of the uninfected cells. A line of human amnion (FL) cells showed a 55 per cent reduction of PE after the establishment of BaEV carrier state. No decrease of PE did occur as a result of BaEV persistent infection in a rhabdomyosarcoma cell line (A204) and in fibroblasts derived from adult human skin. This characteristic reduction of PE in the infected primary embryonic fibroblasts was completely abolished by cultivation of the cells with conditioned medium from confluent either virus-infected or uninfected culture.
A ten-year-old Japanese boy with tricuspid atresia type IB was treated by direct anastomosis from the right atrium (RA) to the right ventricle (RV), entirely with autogenous material. An incision of the RA anterior wall was designed for a flap of RA appendage. A valveless conduit was created, with this flap and a large piece of pericardium. Atrial septal defect (ASD) and ventricular septal defect (VSD) were closed with a patch. Cardiac catheterization and angiocardiography two months postoperatively, showed good results of the surgery.
Kay's mitral valve repair was performed in six consecutive patients with symptomatic mitral regurgitation due to ruptured chordae tendineae of the posterior leaflet. All patients including one with mild residual murmur showed a marked decrease in the heart size and significant clinical improvement. Postoperative hemodynamic studies, performed in four patients, showed restoration of normal or near-normal dynamics. The medium-term follow-up, 15 to 30 months after the operation, revealed continuing asymptomatic states in all. The function of the repaired valves was significantly better than that of the Hancock mitral bioprostheses. The advantages of this procedure compared with mitral valve replacement for the same condition were stressed.
To delineate the process of pancreatic stone formation, stones from four patients were studied with a scanning electron microscope and X-ray probe microanalyser. The stones consisted of a central core and surrounding shell. Two kinds of stones were demonstrated: one had a core composed of a calcium-rich amorphous substance and interlacing fibrils; the other had a core consisting of multiple cavities with smooth walls composed of a calcium-deficient amorphous substance. The shells showed a common structure: zones of layers or bands of a calcium-rich amorphous substance, network fibrils filled with a calcium-rich amorphous substance, and laminated parallelogrammic or polygonal plates of calcite parallel to the surface in one layer and oblique or perpendicular in the next layer. Calcium was in the crypto-crystalline state as well as crystalline state of calcite. Crystalline calcite showed spiral and epitaxial growth along with findings of dissolution, resembling cholesterol crystals of gall stones. Pancreatic stones are probably formed through central core formation and layered growth of a shell. Comparison of stones and protein plugs suggests that protein plugs can grow to stones with calcite deposition accompanied by precipitation of network fibrils and an amorphous substance.
A protective effect of coenzyme Q10 on the ischemic and reperfused myocardium was investigated in the isolated working rat heart preparation. Rats were treated intraperitoneally with 30 mg/kg coenzyme Q10, daily for 7 days. The controls were given the same dose of the vehicle. After 25 min of equilibration the hearts were made totally ischemic at 35.5 degrees C for 30 min, arrested with high potassium cardioplegic solution immediately after aortic cross clamping. The recovery of cardiac power in the coenzyme Q10 pretreated group was significantly (P less than 0.05) better than that in vehicle pretreated group. Creatine phosphokinase (CPK) release during reperfusion was significantly (P less than 0.05) reduced by the pretreatment of coenzyme Q10. Tissue analysis for high energy phosphate compounds revealed no significant difference between the two groups. Tissue lactate content at 30 min of ischemia was significantly (P less than 0.001) lower in the coenzyme Q10 pretreated group. These results suggest that pretreatment with coenzyme Q10 is effective for reducing ischemic injury caused by aortic cross clamping.
A good correlation of Doppler internal carotid blood velocity determinations with hemispheric blood flow measurements by the 133-xenon inhalation method was demonstrated in 14 epileptic patients without abnormal CT findings. The highest correlation was seen between the flow of gray matter (F1) and the internal carotid end-diastolic velocity (d) (left side r = 0.841, right side r = 0.817). As end-diastolic velocity (d) well correlated with the value obtained by the 133-xenon inhalation method, the d value was compared between 77 healthy children and 13 patients with intractable epilepsy. The mean d value of both internal carotid arteries in patients was 16.7 +/- 2.9 mm (mean +/- SD), and that of healthy children 20.9 +/- 4.3 mm, the difference being statistically significant. The low cerebral blood flow in patients might be due to multiple antiepileptic drugs administered and/or mental retardation and cerebral hypofunction related to seizures.
Internal carotid artery flow velocity was evaluated by the Doppler ultrasound method in 32 children with cerebrovascular disease. The average maximal blood velocity (A/L) and end-diastolic blood velocity (d) were compared with each other as indices of blood flow velocity. The right and left mean A/L and d of moyamoya disease were significantly lower than those observed in normal children. The A/L and d of the affected side both in internal carotid artery occlusion and in middle cerebral artery occlusion were also significantly low. In the subarachnoid hemorrhage after rupture, these values were significantly low. In basilar artery occlusion, these values were similar to those in normal children. The results of this study indicate that Doppler ultrasound assessment of internal carotid flow velocity provides noninvasive reliable information for the diagnosis of cerebrovascular disease in childhood.
Sulfated acidic mucopolysaccharides have been found to be significant components of "protein plugs" in patients with chronic pancreatitis. The precise identification of the mucopolysaccharides and their distribution within the protein plugs may clarify the pathogenesis of the plugs. Pure pancreatic juice from five patients with chronic pancreatitis was obtained by endoscopic retrograde catheterization of the papilla of Vater. Enzymes for digestion of the plugs included hyaluronidase of the bovine testes and streptomyces hyalurolyticus, chondroitinase ABC and AC, and sialidase (neuraminidase). Our study indicated that: I) Sialic acid is distributed throughout the plugs and may be a major component, followed by a lesser amount of chondroitin sulfate B. 2) Chondroitin sulfate A, C, D and E and chondroitin may be minor components. 3) Hyaluronic acid is negligible in the plugs.
A neo-adjuvant chemotherapy as a preoperative and preradiation chemotherapy was studied in 60 cases of the head and neck cancers. Out of 60, 29 cases were treated with peplomycin (PEP) and 31 with combination chemotherapies which include vincristine (VCR), methotrexate (MTX), bleomycin (BLM), mitomycin C (MMC); VCR, MTX, BLM (Mathé); VCR, MTX, BLM, 5-FU, hydrocortisone (Price-Hill A); hydoxyurea, adriamycin, BLM; VCR, MTX, PEP; cisplatin (CPDD), PEP. In the group treated with PEP, CR was achieved in one case and PR in 14 cases with a response rate of 52%. Five-year survival by Kaplan-Meier's method after all treatment was 34%. In the group treated with combination chemotherapy, CR was achieved in 5 cases and PR in 19 cases with a response rate of 77%. Three-year survival of this group was 82%. Responders to PEP as well as combination chemotherapy were more often rendered disease-free after all treatment than non-responders. We concluded that two courses of VMP therapy (VCR, MTX, PEP) would be appropriate for the outpatients with advanced stage I or stage II, meanwhile two courses of CP therapy (CPDD, PEP) was inpatients with stage III or stage IV as a neo-adjuvant chemotherapy.
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Responses to different doses of Escherichia coli (E coli; 0-18) injection were studied from the pathological standpoint. Various amounts of live E coli were intravenously injected through the tail vein (group A: 2.7-3.3 X 10(9); B: 1.7-2.0 X 10(9); C: 1.2-1.5 X 10(9); D: 0.3-0.5 X 10(9) organisms/100 g of body weight). All rats from group A died within 6 h; 14 out of 15 rats from group D survived. Hypothermia was commonly seen in the lethal groups (groups A, B, and C) prior to death, and hyperthermia was observed only in groups C and D. Leukopenia was seen in all groups and remained in the lethal groups, whereas in group D, leukocytosis following leukopenia was observed at 12 and 24 h. Light microscopic studies were performed in the lethal groups, showing the following differences among the three lethal groups; a dose-related depletion of white pulp of the spleen, cortical hemorrhage of the adrenal glands (only in groups A and B), foci of bacterial colonies in the heart and small intestine with aggregated leucocytes (only in group C); focal liver necrosis was found in group C, but not in group A. Tubular necrosis and cast formation were also predominant in the kidneys of group C animals. The above findings indicate that the milder, lethal group shows more severe morphological changes in all organs except the spleen and adrenal glands, and suggest that sudden death from bacteremia may involve a depleted host defense.
Systemic hemodynamical responses in anesthetized rats subjected to a bolus IV injection of sonicated (50 watts, 3 min), heat-killed (100 degrees C, 15 min), or live E coli suspension (12-15 X 10(8) E coli organisms in 0.5 ml saline per kg body wt) were continuously monitored for 6 h. A transpulmonary thermodilution method was used for measurement of cardiac output. After injection of sonicated E coli suspension, there was a triphasic hemodynamical response: 1) a hypodynamic state immediately following treatment, 2) a recovery phase, and 3) a profound, progressive hypodynamic state in the late phase. In contrast, heat-killed E coli suspension induced a biphasic response: 1) an insignificant hyperdynamic state in the early phase, and 2) a progressive hypodynamic state in the late phase. An injection of live E coli suspension resulted in a biphasic response: 1) a hyperdynamic state in the early phase, and 2) a progressive hypodynamic state in the late phase.
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The effects of gastrointestinal hormones on gastric carcinomas were examined in vitro and in vivo. In five of seventeen cases of human gastric carcinomas, the uptake of 14C-leucine into the tumor tissue in organ culture was enhanced by 10 micrograms/ml of gastrin. Also, in four of thirteen cases of human gastric carcinomas, the production of 14C-labelled proteins in medium was increased by gastrin. All the cases in which protein synthesis was enhanced by gastrin were histologically poorly differentiated adenocarcinomas. The effects of gastrin and secretin on the growth of gastric carcinoma, which was serially transplanted in athymic mice, were examined. The doubling time of the tumor was 7.1 days. The doubling time was shortened to 4.1 days by daily administration of 250 micrograms/kg of gastrin. This topic effect of gastrin on gastric carcinoma was inhibited by 100 U/kg of secretin. These results showed that the growth and protein synthesis of gastrointestinal tumor may be regulated by gastrointestinal hormones.
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