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N Akaba

Publications and source records attributed to N Akaba.

11 recordsLinked to original sources
PubMed2006

Effect of low-density lipoprotein apheresis on patients with peripheral arterial disease. Peripheral Arterial Disease LDL Apheresis Multicenter Study (P-LAS).

AIM: The effectiveness of low-density lipoprotein (LDL) apheresis for patients with peripheral arterial disease (PAD) was investigated to confirm a hypothesis based on subjective evidence that the amelioration of blood rheology would be the most contributing factor for improvement in clinical symptoms. Evaluation of the severity of intermittent claudication is difficult because of the lack of an accurate parameter to assess muscle ischemia during exercise, thus we objectively evaluated by non-invasive near-infrared spectroscopy (NIRS) on a treadmill in this study. METHODS: Thirty-one patients with PAD were evaluated for hemostatic function and physiological parameters such as ankle-brachial pressure index (ABI), maximum tolerated walking distance (MTWD) and recovery time (RT) or recovery ability index (RAI) on NIRS. Laboratory tests included plasma assays of total cholesterol, LDL-cholesterol, high-density lipoprotein (HDL) cholesterol, triglyceride, and fibrinogen. The change in red-cell filtration rate was evaluated for the improvement of microcirculation. Statistical analysis was performed using the paired Student's t-test with Bonferroni's correction. RESULTS: A significant improvement in ABI and MTWD was observed after average 9.6+/-0.8 sessions of LDL apheresis treatment and the amelioration of microcirculation in ischemic muscle was objectively evaluated as significant improvement in RAI on NIRS. Rest pain was improved in all 5 patients with Fontaine's classification III or IV. A severe ulcer refractory to usual medications was dramatically diminished in the area by 10 sessions of LDL apheresis and fully healed 5 months after the final LDL apheresis treatment followed by medication. No angiographical change was observed in the arterial occlusive lesions in any patients. CONCLUSIONS: The effectiveness of LDL apheresis on the improvement in physiological parameters such as ABI, MTWD and clinical symptoms in patients with PAD was confirmed. The severity of intermittent claudication was objectively evaluated using non-invasive NIRS. The RT or RAI was useful parameter to evaluate the improvement in the ischemic symptoms of the extremities.

Aged↗
PubMed1998

Use of the protective antigen of Erysipelothrix rhusiopathiae in the enzyme-linked immunosorbent assay and latex agglutination.

To establish a safe and convenient serodiagnostic method for swine erysipelas, a purified protective protein antigen of Erysipelothrix rhusiopathiae, which included a large amount of protective protein (64 kDa protein), was used for enzyme-linked immunosorbent assay (ELISA) and the latex agglutination (LA) test. In the ELISA, the antisera to four different serovars (1a, 2, 5 and 20) of E. rhusiopathiae exhibit a positive reaction, while antisera to other species of bacteria (Listeria monocytogenes, Staphylococcus aureus, Streptococcus suis, Rhodococcus equi and Corynebacterium pseudotuberculosis) exhibit a negative reaction. In the LA test, the antisera to three different serovars (1a, 2 and 5) of E. rhusiopathiae reacted with P64-sensitized latex beads, while the antiserum to serovar 20 (2553 strain) did not. Moreover, the antisera to other species of bacteria (Listeria monocytogenes, Staphylococcus aureus, Streptococcus suis, Rhodococcus equi and Corynebacterium pseudotuberculosis) did not in this test. Comparing the results of the growth agglutination (GA), ELISA and LA tests of 284 swine sera, there was a high degree of correlation among the results. The detection of anti-E. rhusiopathiae antibodies in the GA, ELISA and LA tests were compared using sera from pigs immunized with P64, alkaline extract (AE) and live-cell vaccine (LV). In all three tests, anti-E. rhusiopathiae antibodies could be detected 1 week after immunization. The serum antibody titre as determined by the LA test increased moderately, as did that by the GA test, while that determined by ELISA increased rapidly. These results suggested that ELISA could be used to monitor changes in anti-E. rhusiopathiae antibody titre and the LA test could be used in the screening test for swine erysipelas.

Animals↗
PubMed1992

A cylinder-shaped balloon catheter for the management of dissecting aneurysms in acute stage.

We developed a new procedure to close the entry of dissecting aneurysm in acute stage with a specially designed cylinder-shaped balloon catheter. The balloon catheter consists of 7F double lumen catheter and a silicone rubber balloon at the tip. The balloon has a central tube 14 mm caliber made of rigid silicone and it inflates into the shape of a cylinder with an injected solution. The central tube serves as a route for maintaining the aortic blood flow to the distal site. The catheter with a deflated balloon is inserted into the thoracic aorta ascendingly through a 14 or 16 mm caliber Dacron vascular graft sutured at the side of the distal aorta in a similar manner to intra-aortic balloon pumping. The tip of the catheter is carried to the entry tear of the pseudo-lumen. Then the cylinder-shaped balloon is inflated with solution. The entry is, therefore, closed with the side wall of the balloon and the blood stream into the dissected lumen is occluded while maintaining an aortic blood flow to the distal site. To prevent any possible occlusion due to thrombosis, some type of anticoagulant is administered via the catheter connected to a continuous injector. The healing process of the dissected lumen can be enhanced by injecting some type of coagulant directly into the lumen. The treatment is completed when the blood in the false lumen coagulates and stabilizes. The cylinder-shaped balloon is then deflated and the catheter withdrawn. The graft is removed and the stump is sutured.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed1988

[Management of hemoperitoneum due to rupture of visceral branches of the aorta with a cylinder-type balloon catheter].

We have designed a cylinder-type balloon catheter and devised a new procedure for the management of the aneurysm in a condition difficult for treatment. This balloon catheter consists of a balloon located at the tip of a catheter. The balloon has a central lumen for maintaining the distal aortic bloodflow and can be inflated at various intended sites. The catheter with a deflated balloon was inserted into the abdominal aorta upward through a vascular graft sutured at the side of the aorta. In the case of a ruptured visceral artery, e.g., celiac axis or superior mesenteric artery, controlling of hemorrhage is very difficult because the ruptured lesion is surrounded by an intricate anatomical structure and therefore it is necessary to do the highly invasive procedure of aortic cross-clamping. Therefore we attempted this time to use the device in the management of this disease. In experimental investigation in dogs, this balloon selectively blocked the blood flow to the visceral branches successfully while maintaining the distal aortic flow. With this method, the various hemostatic procedures can be performed satisfactorily without concern for complications, namely renal failure provided that hemorrhage is easy to control in a short time without the aortic clamp. As mentioned above, this instrument will be useful for the management of rupture of the visceral artery and so reduce its mortality rate.

Animals↗
PubMed1986

Management of acute aortic dissections with a cylinder-type balloon catheter to close the entry.

Despite recent advances in medical treatment, an acute aortic dissection is still now often fatal because of the seriousness of its condition. The currently available therapies include blocking the progress of dissection with intensive drug therapy, a process leading to the chronic stage. However, the dissection often proceeds rapidly and may result in death. Various surgical procedures have been attempted so far, but they produce highly invasive stress and high risks. Accordingly, we designed a cylinder-type balloon catheter and developed a new closing procedure, wherein a balloon catheter is introduced and inflated at the site with an intimal tear to maintain the blood flow to the distal vessels and also to close the entry. With this procedure, the complaints will be relieved or disappear, the progress of the dissection can be stopped, and the blood flow can be restored to the reduced and collapsed true lumen. When the blood in the pseudolumen becomes coagulated and organized, the balloon is removed. If this catheter is introduced from the femoral artery (similar to an intra-aortic balloon pumping method), the invasive stress will be further reduced. This method appears to be the most useful for DeBakey type III dissections. We are now intensively studying the safe and effective application of this balloon catheter under various clinical conditions.

Aortic Dissection↗
PubMed1983

[A case of sudden gross hematuria caused by an iliac artery-ureteral fistula].

A 51-year-old male patient, who had been treated for nonspecific angitis with pulselessness in the upper extremities, was found to have stenosis of the left common iliac artery. Patch grafting was performed for the stenotic lesion of the artery. Sixteen months after the operation, the patient developed a sudden massive hematuria for which he was immediately admitted. He required blood transfusions and bed rest. Pyelography and arteriography revealed almost complete impairment of the left kidney function. During subsequent left retrograde ureterography , the patient again developed massive hematuria and fell in shock. The ureterogram revealed left hydronephrosis and the adhesive left ureter to the site of the patch graft. Extraluminal outflow of contrast medium into the artery was also noted. These findings were considered to indicate the hematuria being an extravasation of blood from an arterio-ureteral fistula formed in the patch graft region. An emergency operation was performed. Contamination was avoided by construction of the femoro-femoral arterial bypass graft to the left lower extremity, prior to the radical removal of the potentially infected fistula and left kidney. The surgical procedures have saved the patient and his lower extremities.

Acute Disease↗