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Biomedical subjects

N Ohtani

Publications and source records attributed to N Ohtani.

At least 37 records · Page 2Linked to original sources

Tube device for facilitating distal anastomosis in aortic arch replacement.

The technique of placing an inverted graft into the descending thoracic aorta facilitates and secures the distal anastomosis in aortic arch replacement, especially in the anastomosis beyond the transverse arch. We developed a simple technique using a pair of thin-walled tubes to enable the arch graft, with its four branches, to be smoothly inserted into the flaccid, normal-caliber descending aorta. The use of these tubes simplified the procedure, resulting in time saving.

Anastomosis, Surgical↗

Sarcomatous dermatofibrosarcoma protuberans metastasized to the lung: preservation of CD34 expression in tumor cells.

A case of metastatic dermatofibrosarcoma protuberans (DFSP) in a 47-year-old woman is presented. Dermatofibrosarcoma protuberans occasionally recurs, but rarely metastasizes. The patient underwent local removal of the nuchal tumor by a general practitioner, followed by a rapid recurrence. She underwent total removal of the tumor and a diagnosis of spindle cell sarcoma was made after an incisional biopsy was performed. This lesion had both a typical DFSP-like area and a fibrosarcoma (FS)-like area. After 7 years, an abnormal lung shadow was observed and a segmental lung resection was performed. Histologically, the lung tumor was similar to the FS-like area in the nuchal tumor. Confirming CD34 expression in the tumor cells, this lung tumor was diagnosed as metastatic DFSP. Usually CD34 expression is unique to DFSP but almost negative in FS-like areas. In the present case, the FS-like area in the nuchal tumor showed decreased CD34 reactivity, as previously reported, but the FS-like area in the metastatic tumor still widely preserved CD34 expression. The presented case suggests that the FS-like area in DFSP is histogenetically different from typical FS or malignant fibrous histiocytoma.

Antigens, CD34↗

Duodenal but not gastric transection disturbs motility of the sphincter of Oddi in the dog.

The aim of the present study was to elucidate the effect of gastric and duodenal transection on biliary manometry in anesthetized dogs. The basal biliary pressure and increase in pressure during saline perfusion at rates of 1.0 and 1.5 ml/min were studied in intact controls, during infusion of cholecystokinin (CCK) alone, and after gastric and duodenal transection. CCK dose-dependently lowered the basal pressure and the increase in pressure during perfusion. Gastric transection 1.5 cm proximal to the pylorus did not affect these parameters. In contrast, duodenal transection 1.0 cm distal to the pylorus significantly increased these parameters compared to all other groups. These observations suggest that the proximal duodenal transection, as performed during conventional distal gastrectomy, may contribute to the pathogenesis of postgastrectomy gallstone formation by altering motor function of the sphincter of Oddi.

Animals↗

Microdialysis study of modification of hypothalamic neurotransmitters in streptozotocin-diabetic rats.

Neurochemical changes in the ventromedial hypothalamus (VMH) after a single intravenous injection of streptozotocin were examined, using in vivo brain microdialysis under free-moving conditions. Although streptozotocin-induced diabetes produced significant decreases in extracellular concentrations of noradrenaline (NA), serotonin (5-HT), and their metabolites in the VMH, the ratios of 3-methoxy-4-hydroxyphenylglycol/NA and 5-hydroxyindoleacetic acid (5-HIAA)/5-HT were increased. Experimental diabetes led to a pronounced increase in extracellular GABA, which correlated strongly with the decrease in dialysate levels of NA, and to a smaller extent with that of 5-HT. A modification of dopamine (DA) metabolism was induced in the VMH of diabetic rats, whereas there was no change in dialysate DA levels. Daily injections of insulin were able to restore their levels to normal in the areas tested in the microdialysis study. The equal increases in dialysate 5-HT and 5-HIAA and the better restoration of the 5-HIAA/5-HT ratio after insulin therapy indicate that serotonergic activity may depend on the levels of circulating insulin more than on noradrenergic activity. Circulating NA was reduced in streptozotocin-diabetic rats, suggesting that the diabetes-induced reduction in sympathetic activity is accompanied by decreases in NA, or 5-HT, or both, in the VMH.

3,4-Dihydroxyphenylacetic Acid↗

Purification and partial characterization of a novel human platelet aggregation factor in the extracellular products of Streptococcus mitis, strain Nm-65.

A human blood platelet aggregation factor was purified from the extracellular products (ECP) of Streptococcus mitis, strain Nm-65 by sequential chromatography on DEAE-Sepharose CL-6B, hydroxyapatite and Superdex 75 columns. The purified factor (S. mitis-derived human platelet aggregation factor, Sm-hPAF) gave a single band with a molecular weight of 66 kDa on SDS-polyacrylamide gel electrophoresis (SDS-PAGE). Sm-hPAF showed a peak absorption at 278 nm and an isoelectric point of around 8.5. Chemical analyses revealed that Sm-hPAF contained no sugars and that its first 15 amino-terminal amino acid residues were H-DEQGNRPVETENIAR. Platelet aggregation activity of Sm-hPAF was abolished by heating at 45 degrees C for 10 min. Platelet aggregation by Sm-hPAF was accompanied by a release of prostaglandin E2 (PGE2) in a dose-dependent manner. The platelet aggregation was not inhibited by either prostaglandin E1 (PGE1) or Gly-Arg-Gly-Asp-Ser (GRGDS), that inhibit the platelet aggregation induced by collagen. Twenty (77%) platelet rich-plasma (PRP) specimens derived from 26 healthy volunteers were aggregated by Sm-hPAF, but the remaining 6 (23%) were not reactive. A preliminary study suggested the presence of an inhibitory factor against Sm-hPAF in the plasma from a non-reactive donor.

Adult↗

[Dural arteriovenous fistula presenting as acute-onset dementia: a case report].

We report here a unique case of acute-onset dementia caused by a posterior fossa dural arteriovenous fistula (AVF), which was successfully treated by surgical resection of the isolated transverse-sigmoid sinus combined with endovascular procedures. A 70-year-old female was admitted to our hospital with acute-onset dementia and pulsatile tinnitus on the left side. CT scan revealed a low-density area in the parieto-temporal region. Cerebral angiography revealed a dural AVF of the transverse-sigmoid sinus with retrograde drainage into cerebral cortical veins. After transarterial endovascular embolization of the dural AVF, a xenon-CT scan revealed increased cerebral blood flow. Four months postoperatively, however, she was admitted to our hospital again with seizure and aphasia due to recanalizaion of the dural AVF. After trans-arterial embolization, transvenous embolization was attempted, but was unsuccessful due to inaccessibility of the isolated sinus segment. Since this patient could not be cured by endovascular embolization, an open surgical resection of the isolated sinus segment was performed. Following this, CT scans revealed that the low density area present on the first admission had disappeared. The patient's dementia resolved postoperatively. We discuss the pathophysiological mechanism by which venous ischemia due to dural AVF can cause reversible dementia.

Acute Disease↗

[A case of ruptured aortic arch aneurysm with hemorrhagic cardiac tamponade].

The ruptured thoracic aortic aneurysm is still a dramatic even with very poor outcome, whereby its survival depends largely on early diagnosis and operation. We report a successful case of aortic arch replacement for ruptured aortic arch aneurysm with cardiac tamponade. Lethal hemopericardium causing cardiac tamponade is most commonly seen as a complication of acute myocardial infarction or acute aortic dissection, and subsequent rupture of the heart or ascending aorta leads to the rapid accumulation of blood within the poorly distensible pericardial sac. Our case was operated upon emergency basis due to hemopericardium. On operative findings, the aortic aneurysm located the minor curvature of aortic arch and was a huge saccular shape. In surgical procedure, the total arch replacement was completed using selective cerebral antegrade perfusion with deep hypothermia. Postoperative course was uneventful and no cerebral complication was observed after surgery.

Aortic Aneurysm, Thoracic↗

[Purification and partial characterization of a novel human platelet aggregation factor in the extracellular products of Streptococcus mitis, strain Nm-65].

In this paper, we report the purification and partial characterization of human platelet aggregation factor form the extracellular products (ECP) of Streptococcus mitis (S. mitis) isolated from a patient with Kawasaki disease (KD). Platelet aggregation reaction was carried out using platelet-rich plasma (PRP) and washed platelets suspended in ACD-PBS. The aggregation factor was designated as S. mitis-derived human platelet aggregation factor (Sm-hPAF). The results obtained were as follows. 1) Sm-hPAF was isolated by chromatography on DEAE-Sepharose CL-6 B, hydroxyapatite and Superdex 75 columns. The purified Sm-hPAF showed a single band upon SDS-polyacrylamide gel electrophoresis (SDS-PAGE) and molecular weight of approximately 66 kDa on SDS-PAGE. The isoelectric point (pI) of Sm-hPAF was 8.5, and Sm-hPAF showed an absorption peak at 278 nm on absorption spectra. When the platelet aggregation activity of the Sm-hPAF was compared with that of ECP, the specific aggregation activity of the of Sm-hPAF was significantly increased (up to 28-fold). Sugars were not found in Sm-hPAF. The sequence of the first 15 amino-terminal amino acid residues were H.Asp-Glu-Gln-Gly-Asn-Arg-Pro-Val-Glu-Thr-Glu-Asn-Ile-Ala-Arg. The platelet aggregation activity of Sm-hPAF was inactivated by heating at 45 degrees C for 10 min. 2) PGE2 was released from platelets after incubation for 10 min with Sm-hPAF in a dose-dependent fashion. Platelet aggregation by the Sm-hPAF was totally inhibited by either PGE1, or GRGDS, but these reagents did not inhibit the platelet aggregation by collagen. 3) Histological examination of the rabbit skin sites showing an early reaction revealed increased dilatation of the veins and capillaries with cellular infiltration in the perivascular space of the dermis. Hyperplasia of the endothelial cells was noted. Degeneration of the vascular walls was observed in the later stages of the reaction. Aggregation of red cells in the vascular endothelium was also observed. Sm-hPAF was capable of producing vasculitis. 4) Twenty (76.9%) platelet-rich plasma samples (PRP) derived from 26 healthy human volunteers reacted with Sm-hPAF, but the remaining 6 PRPs were not reactive. Preliminary study suggests the existence of an inhibitory factor in plasma from nonreactive donors.

Animals↗

[Laser Doppler flowmetry of the bulbar conjunctiva as a monitor of the cerebral blood flow].

In order to develop a non-invasive monitor of cerebral blood flow during aortic arch surgery, reliability of the laser Doppler flowmetry of the bulbar conjunctiva was evaluated. The blood flow of the bulbar conjunctiva may represent the cerebral blood flow because the ophthalmic artery originating from the internal carotid artery supplies the blood to the bulbar conjunctiva. A laser Doppler flowmeter (Advance Co., ALF201) and a specially designed probe was prepared to measure the blood flow of the bulbar conjunctiva. The probe was designed to stay in a fixed position on the bulbar conjunctiva when the eye lid is closed, so that it can maintain a stable measurement. The shape of probe is a small box, 7.5 x 4.0 x 2.0 mm connected to a glass fiber cable 2 mm in diameter, as the signal to convey to the flowmeter. Eight mongrel dogs were used for the experimental study. The brachiocephalic vessels were exposed to measure the pressure and the blood flow of the carotid arteries. The blood flow of the cerebral cortex and the bulbar conjunctiva was measured by the laser Doppler flowmetry. When the carotid artery was clamped, the blood flow of the bulbar conjunctiva fell instantaneously in 1.35 +/- 0.85 seconds and reached the plateau in 9.60 +/- 4.15 seconds. The flow returned to the previous value in 7.70 +/- 3.75 seconds after the clamp was removed. A significant positive correlation between the blood flow of the bulbar conjunctiva and that of the cerebral cortex was observed (r = 0.78, p < 0.001, n = 2). When the extracorporeal circulation was used, the waveform of the bulbar conjunctival blood flow was synchronized to the small pulse wave generated by the pump. Although the measurement of the bulbar conjunctival blood flow by laser Doppler flowmetry is an indirect method of monitoring the cerebral blood flow, it can provide non-invasive, continuous, and reliable measurement. We conclude that this is a useful method to monitor the cerebral blood flow during aortic arch surgery.

Animals↗

Intragastric capsaicin stimulates colonic motility via a neural reflex in conscious dogs.

BACKGROUND & AIMS: Capsaicin is known to contract smooth muscles and to have an excitatory action on thin, primary afferent neurons. The aim of this study was to test the hypothesis that intragastric capsaicin may have an excitatory effect on colonic motility. METHODS: Mongrel dogs equipped with five strain-gauge force transducers on the colon (C1-C5) were used. In 5 dogs, the effect of intragastric capsaicin (0.05, 0.1, 0.3, and 0.5 mg/kg) on colonic motility in the presence or absence of the cholinergic blockers atropine and hexamethonium was studied. In 4 dogs, the effect of capsaicin (0.5 mg/kg) administration into a vagally innervated or denervated gastric pouch on colonic motility was investigated. RESULTS: Motility at C2-C3, C1-C3, and C1-C5 was significantly increased by 0.1, 0.3, and 0.5 mg/kg of capsaicin, respectively. The excitatory effect of capsaicin on colonic motility was inhibited by atropine and hexamethonium. Colonic motility at C1-C4 was significantly increased by capsaicin administration into a vagally innervated pouch but was not affected by capsaicin administration into a vagally denervated pouch. CONCLUSIONS: These results indicate that intragastric capsaicin predominantly stimulates motility in the proximal half of the colon through neural pathways, probably through a vagovagal reflex, but sympathetic involvement cannot be excluded.

Animals↗

Superantigenic exotoxin production by isolates of Staphylococcus aureus from the Kawasaki syndrome patients and age-matched control children.

Nineteen strains of Staphylococcus aureus were isolated from the throat or the tooth surfaces of 19 cases amongst 127 patients with Kawasaki syndrome (KS) during the acute phases and 11 S. aureus isolates were obtained from five of 17 diseased controls and six healthy controls. The production of exotoxins, particularly superantigenic toxic shock syndrome toxin-1 (TSST-1), coagulase serotype, pigment production, haemolytic activity and tryptophan auxotrophy of these isolates were compared. Among 10 KS S. aureus strains isolated in 1990-1991, five (50%) secreted TSST-1, a higher frequency than two (18%) of 11 control isolates. In contrast, none of the nine KS strains collected in 1984 produced TSST-1. Four of five TSST-1-secreting KS strains produced white or white to golden pigmentation, whereas the two control strains capable of TSST-1 production formed golden colonies. There were no noticeable differences between S. aureus strains from KS patients and control children in the production of staphylococcal exotoxins A-E, coagulase serotype, haemolysis of sheep erythrocytes and tryptophan auxotrophy. The pathological or aetiological role of a new TSST-1-secreting S. aureus clone in patients with KS was not confirmed.

Bacterial Toxins↗

[Gastric emptying of semi-solid meal in normal man with special reference to relationship between plasma acetoaminophen concentrations and gastric emptying time].

Correlation between gastric emptying time measured by a radioisotope method and plasma acetoaminophen level was studied in 11 preoperative early gastric cancer in semisolid meal. A significant correlation was found between both gastric emptying half-time and plasma acetoaminophen level at 30, 45 minutes after ingestion of meal, and plasma acetoaminophen level at maximum. We conclude that acetoaminophen analysis is useful to measure gastric emptying at semisolid meal.

Acetaminophen↗

Effect of motilin on colonic motor activity in the interdigestive state in conscious dogs.

The aim of the present study was to investigate the effect of motilin at various doses on colonic motility in the interdigestive state. Colonic motility was investigated in five dogs equipped with strain gauge force transducers on the gastric antrum, and on the proximal, middle, and distal colon. Exogenously infused motilin (0.2, 0.5, 1.0 and 2.0 micrograms/kg-hr) dose-dependently increased colonic motility, but the doses of motilin that significantly enhanced colonic motility were 1.0 and 2.0 micrograms/kg-hr in all areas of the colon. Motilin at 0.2 microgram/kg-hr increased the plasma motilin concentration to almost equal to the physiological peak values. The excitatory effect of motilin (2.0 microgram/kg-hr) was abolished by atropine but was not affected by hexamethonium. These results indicate that exogenously infused motilin, which increased plasma motilin concentration to above the physiological peak level, stimulated colonic motility by affecting postsynaptic cholinergic neurons.

Animals↗

Gastrointestinal motor activity after pylorus-preserving gastrectomy with or without vagotomy in dogs.

BACKGROUND: In the present study we evaluated gastrointestinal motility after gastrectomy of a new pylorus-preserving technique that is becoming a popular operation for early stage carcinoma of the stomach. STUDY DESIGN: Using strain-gauge force transducers we studied gastrointestinal motility in control dogs, dogs after pylorus-preserving gastrectomy, and dogs after conventional distal gastrectomy with Billroth I reconstruction. Dogs with gastrectomy were reoperated upon after recording motility patterns, and the effect of vagal denervation of the gastric remnant on motility was investigated. Overall motility pattern, length of the digestive phase in the jejunum, and interval of the interdigestive phase III contractions were studied and compared among the three groups. RESULTS: In dogs after gastrectomy without vagal denervation, the regular occurrence of interdigestive phase III contractions from the gastric remnant to the jejunum was identified. In dogs after gastrectomy with vagal denervation, however, no apparent interdigestive phase III contractions were observed in the gastric remnant. The duration of the digestive phase in the jejunum, which correlates with postprandial gastric emptying, was not different between the control dogs and the dogs having pylorus-preserving gastrectomy. However, this duration was significantly shorter in dogs having conventional distal gastrectomy compared with the control dogs, not only before but after vagal denervation. CONCLUSIONS: These results indicate that the postoperative motor function after pylorus-preserving gastrectomy may be superior to that after conventional distal gastrectomy with Billroth I reconstruction.

Animals↗

Effects of substance P on gastric motility differ depending on the sites and vagal innervation in conscious dogs.

The effect of substance P on gastric motility was studied in conscious dogs by means of strain gauge force transducers chronically implanted on the gastric body, antrum, and a vagally-denervated fundic pouch. Intravenous infusion of substance P in the interdigestive state induced phasic contractions in the pouch and antrum. Atropine inhibited these contractions in the pouch and antrum. Hexamethonium enhanced substance P-induced contractions in the gastric antrum, but reduced those in the pouch. Pretreatment with phentolamine, propranolol, or naloxone did not affect substance P-induced contractions in the pouch and antrum. The intact gastric body scarcely reacted to substance P. Mean systemic blood pressure was lowered by substance P-infusion, but there was no dose-dependency in the reduction of the blood pressure, nor was it affected by the pretreatment with atropine or hexamethonium. These results suggest that 1) the vagal innervation influences the effect of substance P on motility in the gastric body, and that 2) substance P may stimulate postsynaptic excitatory cholinergic and presynaptic inhibitory neurons simultaneously in the gastric antrum.

Animals↗