PubMed Health⌕ Search

Biomedical subjects

N Otani

Publications and source records attributed to N Otani.

At least 37 records · Page 2Linked to original sources
PubMed1998

Importance of left anterior descending coronary artery curvature in determining cross-sectional plaque distribution assessed by intravascular ultrasound.

We assessed the relation between the circumferential distribution of coronary atherosclerotic plaques and the structure of the epicardial coronary arteries in patients with coronary artery disease using intravascular ultrasound in vivo. Coronary atherosclerosis preferentially formed at the inner arc of the curved coronary vessels, and greater vessel curvatures were associated with greater distributions of atherosclerotic lesions along the inner coronary artery wall.

Adult↗
PubMed1996

Early results of a reinforced biosynthetic ovine collagen vascular prosthesis for small arterial reconstruction.

The efficacy of a reinforced biosynthetic ovine collagen (RBOC) vascular prosthesis developed for small arterial reconstruction was assessed by examining 30 grafts in 29 patients with arteriosclerosis obliterans. The operative procedures performed were femorofemoral bypass in 2 patients, above-knee femoropopliteal bypass in 28 patients, and below-knee femoropopliteal bypass in 1 patient. Femoropopliteal bypass was simultaneously performed in two patients undergoing femorofemoral bypass using one or two grafts. The indications for surgery were intermittent claudication in 27 patients and to salvage the limb in 2 patients. The longest follow-up period was 49 months, and there were six graft failures, occurring 1, 1, 9, 17, 17, and 23 months after implantation, respectively; caused by compression of the graft from outside in two, infection in one, anastomotic intimal hyperplasia in one, and unknown factors in two. Thus, the primary cumulative patency rate for above-knee femoropopliteal bypass at 3 years was 83.7%, and the secondary patency rate was 91.2%. No aneurysmal change was observed. Moreover, the RBOC was able to be used without preclotting, and its handling and suturing characteristics were satisfactory. Our findings suggest that this vascular prosthesis may be an acceptable alternative for above-knee femoropopliteal bypass.

Aged↗
PubMed1996

Limitations of intravascular ultrasound for the evaluation of coronary luminal area--comparison with quantitative angiography.

To evaluate the accuracy of intravascular ultrasound (IVUS) for the measurement of coronary luminal area, we compared IVUS with quantitative coronary angiography (QCA). We studied 46 segments in 21 patients who underwent coronary intervention. In each lesion, coronary luminal areas were evaluated by both IVUS and QCA. To quantitate the differences between the two modalities, we calculated a difference index (magnitude of intraluminal area by IVUS -intraluminal area by QCA/intraluminal area by IVUS). We also calculated an eccentricity index (the thinnest thickness of plaque divided by the width of the opposite plaque) using IVUS. All samples were classified into 2 groups according to the lumen diameter by QCA. In Group I (lumen diameter > or = 3.0 mm), we found a close correlation between the intraluminal areas obtained by the two modalities (r = 0.95, p < 0.001). In Group II (lumen diameter < 3.0 mm), we found a lower correlation between the intraluminal areas obtained by the two techniques (r = 0.61, p < 0.005), and the intraluminal area by IVUS was significantly larger than that from QCA (p < 0.001). Furthermore, there was an inverse correlation between the eccentricity index and the difference index in Group II (r = 0.83, p < 0.001). These findings indicate that the differences between ultrasonic and angiographic measurements the coronary luminal area were greater in coronary arteries with a narrow lumen due to plaque eccentricity.

Aged↗
PubMed1996

Recombinant tissue plasminogen activator prevents intimal hyperplasia after balloon angioplasty in hypercholesterolemic rabbits.

The purpose of this study was to clarify whether continuous infusion of recombinant tissue plasminogen activator (rtPA) prevents intimal hyperplasia at the site of arterial injury. Forty-three Kurosawa and Kusanagi hypercholesterolemic (KHC) rabbits which underwent balloon angioplasty of the right common iliac artery were randomly divided into 2 groups; rtPA for 7 days (n = 29) and untreated (n = 14). The former group was subdivided into a high-dose group (n = 15) (2 mg/kg per day continuously for 7 days after 3 mg/kg for 4h) and a low-dose group (n = 14) (0.6 mg/kg per day for 7 days after 0.6 mg/kg for 4 h). Balloon angioplasty was performed with a 2.5-mm balloon (3 x 60-sec, 6-atm inflations at 60-sec intervals) 1 h after the initiation of rtPA infusion via an ear vein. The iliac arteries of the rabbits were histologically studied at 28 days. The cross-sectional areas of the intima, media, and adventitia were calculated at the site of intimal hyperplasia. The intimal cross-sectional area was 0.07 +/- 0.11 (mean +/- SD) mm2 for the high-dose rtPA group and 0.11 +/- 0.07 mm2 for the low-dose rtPA group, and both of these values were significantly less than that for the control group (0.57 +/- 0.21 mm2 p < 0.01). The ratio of the intimal to medial cross-sectional area was significantly (p < 0.01) lower for the rtPA groups than for the control group (high-dose rtPA; 0.10 +/- 0.13, low-dose rtPA; 0.21 +/- 0.19, control; 1.25 +/- 0.55). In conclusion, continuous infusion of rtPA for 7 days prevented intimal hyperplasia after balloon injury.

Angioplasty, Balloon↗
PubMed1996

[Prevention of left ventricular aneurysm formation and left ventricular remodeling caused by percutaneous transluminal coronary angioplasty performed 24-48 hours after onset of acute myocardial infarction].

The prevention of left ventricular aneurysm formation and left ventricular remodeling by percutaneous transluminal coronary angioplasty (PTCA) performed 24 to 48 hours after onset of acute myocardial infarction was investigated. Left ventriculography and coronary angiography were performed in 25 patients within 24 hours of onset of acute myocardial infarction. The patients were divided into two groups; reperfusion group (n = 17) and successful PTCA group (n = 8). The reperfusion group and the PTCA group included patients whose infarct-related coronary arteries were successfully reperfused to 99%, Thrombolysis in Myocardial Infarction (TIMI) grade II or III, immediately after coronary thrombolysis. However, the reperfusion group did not include the patients with spontaneous reperfusion or reperfusion after PTCA. The PTCA group consisted of patients who underwent successful PTCA performed within 24 to 48 hours after onset of infarction (mean 28.4 +/- 6.0 hours). Non-reperfusion in the acute phase was defined as TIMI grade 0-I. The size of the ventricular aneurysm in the PTCA group was significantly reduced compared with the reperfusion group (PTCA group 4.2 +/- 8.7%, reperfusion group 27.2 +/- 6.6%; p < 0.01). The increase of left ventricular end-diastolic volume (delta LVEDVI) from the acute to chronic phases was calculated to estimate left ventricular remodeling. There was a significant difference between the two groups in delta LVEDVI (PTCA group 4 +/- 19 ml/m2, reperfusion group 19 +/- 17 ml/m2; p < 0.05). PTCA performed within 24 to 48 hours after onset in patients with acute myocardial infarction and infarct-related coronary arteries, resulting in reperfusion to 99% TIMI grade II or III immediately after coronary thrombolysis, prevents left ventricular aneurysm formation and remodeling.

Aged↗
PubMed1995

[Clinical efficacy of neoadjuvant M-VAC chemotherapy for invasive bladder cancer].

We clinically evaluated the efficacy of neoadjuvant M-VAC (methotrexate, vinblastine, doxorubicin and cisplatin) therapy followed by radical cystectomy. A total of 21 patients with locally invasive bladder cancer received neoadjuvant M-VAC therapy with an average of 2.4 courses (range 2-4). Of the 21 patients, 4 had stage T2N0M0, 11 had stage T3aN0M0, 5 had stage T3bN0M0 and 1 had stage T4N0M0 at diagnosis. Of the 21 patients, 3 had clinically complete responses (cCR) and 12 had partial responses (cPR), for an overall response rate of 71.4%. The patients who responded to the chemotherapy (cCR + cPR) had a 2-year disease free rate of 80.0% in contrast to 50.0% for the remaining patients who did not respond. A pathological response (pT0, pT1) was achieved in 6 (28.6%) of the 21 patients. The 5 patients in this group remain free of disease for 15 to 79 months (mean 58.8 months). These preliminary results suggest that the patients who achieve either a complete or partial response, in particular those had pathological stage of pT0 or pT1, may have a favorable clinical course.

Adult↗
PubMed1995

[Emergency CABG and mitral valve replacement for anterolateral papillary muscle rupture after acute myocardial infarction].

A 74-year-old man developed sudden cardiogenic shock 5 days after the onset of acute myocardial infarction. Echocardiographic diagnosis was severe mitral regurgitation due to papillary muscle rupture. Despite the effort to support the hemodynamics with catecholamines and IABP, the patient's condition deteriorated rapidly, which necessitated emergency operation. Anterolateral papillary muscle was found to be totally ruptured. Coronary artery revascularization and mitral valve replacement were performed. Postoperative course was uneventful, with two days of IABP and three days of ventilatory support. The patient could start rehabilitation program on the 7th postoperative day. He was discharged in 2 months in NYHA class I. Reports of successful emergency operation for total papillary muscle rupture following acute myocardial infarction are rare. Involvement of anterolateral papillary muscle is rarer. Early diagnosis and surgical treatment are mandatory to save this group of patients.

Aged↗
PubMed1995

[Allergy histories of Brazilian residents of Japanese descent in Japan].

A questionnaire written in Portuguese was administered from December 1993 to February 1994 to study the frequency of allergic symptoms among Brazilians of Japanese descent in Japan. The results obtained were as follows. 1) The frequencies of allergy histories were 18% for allergic rhinitis, 14% for atopic dermatitis, 12% for alimentary allergy, 10% for allergic conjunctivitis, 9% for allergy to metals, 8% for drug allergy, 7% each for urticaria and pollinosis, and 5% for asthma. 2) The frequencies of allergic rhinitis, allergic conjunctivitis, pollinosis, urticaria and drug allergy were higher among those who came from metropolitan districts in Brazil with severe environmental pollution compared to those who came from rural districts. 3) The characteristics of persons who had subjective symptoms of pollinosis in early spring during their stay in Japan were as follows: The districts they resided in while in Japan were in the Kanto area where the frequencies of Japanese-cedar pollen-specific IgE antibodies positives were high and also where the frequencies of Japanese cedar pollinosis were high among Japanese living in Japan. The districts they originally came from were the metropolitan areas in Brazil, and they were resident in Japan for more than one year.

Adult↗
PubMed1994

Influence of growth factors on in vitro invasiveness and type IV collagenolysis of human renal cell carcinoma cells.

We investigated the influence of epidermal growth factor (EGF) and transforming growth factor (TGF)-beta 1 on the in vitro invasion and type IV collagenolytic activity of two new cell lines of renal cell carcinoma (SRCC-1P and SRCC-1M). When cells were treated with EGF or with TGF-beta 1, EGF increased the number of cells penetrating through the reconstituted basement membrane in SRCC-1P. In contrast, TGF-beta 1 suppressed the number of cells penetrating through the membrane in SRCC-1M. In accordance with the invasiveness, EGF enhanced the activity of type IV collagenolysis in SRCC-1P, and TGF-beta 1 suppressed it in SRCC-1M. The growth factors did not affect DNA synthesis of the cells as evaluated by 3H-thymidine incorporation. These results suggest that EGF and TGF-beta 1 can influence the in vitro invasive process of renal cell carcinoma cells through their actions on proteolysis such as type IV collagenolysis.

Carcinoma, Renal Cell↗
PubMed1994

Bladder carcinoma producing granulocyte colony-stimulating factor.

A patient presented with grade 3 transitional cell carcinoma of the bladder showing a marked increase in granulocyte colony-stimulating factor (G-CSF). G-CSF was identified in the carcinoma by immunohistochemical procedures. The serum and urinary levels of G-CSF were persistently elevated during his clinical course. These results suggest that the carcinoma produced G-CSF and was responsible for its high levels in serum and urine.

Aged↗
PubMed1994

[A questionnaire survey on urinary incontinence and urinary disturbances in the institutionalized elderly with senile dementia].

We carried out a questionnaire survey concerning urinary disturbances, among nursing home patients. The answers were obtained from 1,038 elderly including 355 males and 683 females. Ages, spanned 50-99, with an average age of 79.1. Of the 1,038 respondents which we obtained through our survey for management of urination, 35.8% of the total said that they are able to urinate without incontinence. Those able to urinate with incontinence accounted for 23.6% of the total. However, 40% of all patients required an adult diaper throughout the day to control their urinary functions. Patients suffering from neurological disorders accounted for 70% of respondents, and a correlation was seen between the extent of dementia and ADL, and excretory control. Urinary functioning in both men and women was found to grow increasingly difficult with age, and medical problems involving urinary difficulty appear to increase with the advance of the aging process. The representative groups for this survey were limited to elderly people in nursing homes, many of whom suffer from neurological disorders such as cerebral infarction. It was found that both male and female patients experience a variety of urinary disturbances.

Aged↗
PubMed1994

[A case report of innominate and carotid artery aneurysms causing cerebral embolism].

Brachiocephalic aneurysms are relatively rare in Japan. A case with tandem aneurysms of innominate and right carotid artery was experienced and its successful surgical treatment was reported. A 54-year-old female patient had an attack of cerebral infarction with left hemiparesis. Computed tomography and angiogram revealed aneurysms of innominate and right carotid artery causing cerebral embolisms. Aneurysmectomy and replacement with Dacron prosthesis was performed. A temporary shunt was utilized between ascending aorta and common carotid artery during clamping carotid artery. She had no problems after operation, and her postoperative course was uneventful.

Anastomosis, Surgical↗
PubMed1993

In vitro invasive potential and type IV collagenolytic activity of human renal cell carcinoma cells derived from primary and metastatic lesions.

We investigated in vitro invasiveness and type IV collagenolytic activity of cells from a primary and a metastatic lesion of a patient with renal cell carcinoma. The temporarily cultured cells (SRCC-1P) derived from the primary lesion and those (SRCC-1M) from the metastatic lesion exhibited positive staining for both cytokeratin and vimentin, indicating that they were of renal cell carcinoma origin. An in vitro invasion assay revealed that the cells of SRCC-1M were significantly more invasive than those of SRCC-1P, which showed only marginal invasion. Type IV collagenolytic activity correlated with the in vitro invasiveness, in which SRCC-1M apparently had the higher activity. These results indicate that type IV collagenolytic activity contributes to the invasiveness of the cells in vitro.

Adrenal Gland Neoplasms↗
PubMed1993

Intense sympathetic stimulation releases neuropeptide Y but fails to evoke sustained coronary vasoconstriction in dogs.

We determined whether a 3-minute period of intense cardiac sympathetic stimulation, which is known to release neuropeptide Y (NPY), elicits a sustained poststimulatory coronary vasoconstriction in anesthetized dogs that had received propranolol. We also periodically measured the cardiac chronotropic responses to test vagal stimulations; these responses served as an index of the neuronal release of NPY. In a group of 11 animals, the coronary vascular resistance increased by 14 +/- 4% during the sympathetic stimulation. After cessation of stimulation, however, coronary vascular resistance returned rapidly to its control value. The cardiac responses to the test vagal stimuli were attenuated by approximately 40% after cessation of sympathetic stimulation, and this inhibitory effect persisted for approximately 60 minutes. In a second group of eight dogs, we determined whether the intense sympathetic stimulation potentiates the coronary vascular responses to exogenous norepinephrine (NE). Before sympathetic stimulation, standard intracoronary infusions of NE increased coronary vascular resistance by 14 +/- 2%. Intense antecedent sympathetic stimulation did not alter the coronary vascular responses to subsequent NE infusions. However, the chronotropic responses to test vagal stimuli were initially attenuated by approximately 30%, and this inhibitory effect persisted for approximately 1 hour. In a third group of four dogs, we found that exogenous NPY significantly potentiated the coronary vasoconstriction evoked by NE infusions. The coronary vascular responses to combined infusions of NE and NPY were consistently greater (by approximately 13%) than the sum of the responses to these substances when they were infused separately. We conclude that, even though sufficient NPY appears to be released from the sympathetic nerve endings to inhibit vagal neurotransmission, the quantity of NPY released into the coronary blood vessels under the conditions of our experiments appears to be insufficient either to elicit a sustained coronary vasoconstriction or to potentiate the vasoconstrictor effects of intracoronary NE infusions.

Animals↗
PubMed1993

[A case of B-chronic lymphocytic leukemia/prolymphocytic leukemia (CLL/PL)].

A 59-year-old man was admitted to our hospital on May 17, 1991 because of dizziness and a sense of abdominal fullness. Physical examination on admission showed splenomegaly without hepatomegaly or lymphadenopathy, and blood examination revealed normocytic anemia, thrombocytopenia and marked leukocytosis of 16,800/microliters with 87% lymphoid cells. Prolymphocytoid cells formed 28% of the lymphoid cells. Bone marrow aspiration revealed massive infiltration of lymphoid cells. Surface marker analysis showed that the lymphoid cells were positive for anti-HLA-DR, CD 5, CD19, CD20, CD21, SmIgM and SmIgD. The patient was diagnosed as having B-CLL/PL, according to the classification advocated by Melo in 1986, and initially treated with vindesine + prednisolone + pirarubicin (VP-THP). However, the prolymphocyte count increased, so we changed to VP-THP + cyclophosphamide (VEP-THP), and remission was obtained. CLL/PL is a rare disease in Japan but we obtained a good response to chemotherapy.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1993

[A case report of a chronic traumatic thoracic aneurysm].

A successful experience of a case with chronic traumatic thoracic aneurysm is reported. A 51-year-old male patient had a history of a blunt chest trauma in a traffic accident one and a half year ago. He developed gradual hoarseness because of the recurrence nerve paralysis. Computed tomography and angiography revealed a saccular aneurysm at thoracic descending aorta. It was treated with direct closure of the tear under partial clamp of the aorta. His postoperative course was excellent. He is doing well two years after operation.

Accidents, Traffic↗
PubMed1992

Tumor size of renal cell carcinoma: its clinical implication.

We studied the clinical implication of tumor size in renal cell carcinoma, by revealing its relation with the other histopathological and clinical features. The tumor size was well correlated with histopathological findings and metastatic status of the carcinoma. Smaller carcinomas (usually less than 60 mm) generally had a higher disease-specific survival than those of 60 mm or greater. The results indicated that the size reflected the biological character of the carcinoma. However, 10% of patients with the smaller carcinoma had lymph node metastasis or distant metastasis at the time of diagnosis, each of which contributed to a renal cell carcinoma-related death in the early follow-up period.

Carcinoma, Renal Cell↗