[A case of occult insulinoma localized by intra-arterial stimulation with calcium and venous sampling technic].
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Biomedical subjects
Publications and source records attributed to S Komatsu.
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Thirty-two consecutive patients with thoracic aortic aneurysms who required aortic arch reconstruction were operated on with the aid of extracorporeal circulation and selective cerebral perfusion between January 1986 and August 1990. For selective cerebral perfusion, blood was infused into both the innominate and left common carotid arteries at a rate of 10 mL.kg-1.min-1 using a single roller pump separately from the systemic circulation. In 9 patients treated before March 1987, the operations were performed without open aortic anastomosis (group 1), whereas in 23 patients treated from March 1987 onward we used open aortic anastomosis (group 2). The extracorporeal circulation and cardiac arrest times were significantly longer in group 2, but there was no significant difference in the cerebral perfusion time. Early death occurred in 1 patient in group 1 and 2 in group 2. No serious cerebrospinal neurological complications occurred in either group, and there were similar rates of postoperative hepatic and renal dysfunction in both groups. The present data suggest that selective cerebral perfusion and open aortic anastomosis are useful methods for thoracic aortic aneurysm operation requiring complex repair of the aortic arch.
The globulin of the seed endosperms of rice has an isoelectric point of 6.4 and a M(r) of 26,000. There is one intra-disulphide bond, but no N-linked oligosaccharide chain. The amino acid sequence of the N-terminal and internal regions of the globulin was determined and found to be homologous with that of glutenin, the storage protein in the seed endosperms of wheat. Rice globulin and wheat glutenin were rich in glycine, and glutamic acid or glutamine, and in addition, wheat glutenin cross-reacted with antibody raised against rice globulin. These results suggest that rice seed globulin represents a protein similar to wheat seed glutenin.
A method was developed for direct microsequencing of N alpha-acetylated proteins electroblotted onto polyvinylidene difluoride membranes from polyacrylamide gels. N alpha-Acetylated proteins (greater than 32 pmol), including horse heart cytochrome c, five mutants of yeast cytochrome c, and bovine erythrocyte superoxide dismutase, were separated by SDS-PAGE and electroblotted onto polyvinylidene difluoride membranes. The portions of the membrane carrying the bands were cut out and treated with 0.5% polyvinylpyrrolidone in acetic acid solution at 37 degrees C for 30 min. The protein was digested on the membrane with 5-10 micrograms of trypsin at 37 degrees C for 24 h. During tryptic digestion, the resultant peptides were released from the membrane and the N-terminal peptide was efficiently deblocked with 50 mU of acylamino acid-releasing enzyme at 37 degrees C for 12 h. Picomole levels of the deblocked proteins could be sequenced directly by use of a gas-phase protein sequencer.
Calcium and phospholipid-dependent protein kinase (PKC) activity was detected mainly in the cytosol of the mouse sperm. The PKC in the cytosol fraction was partially purified by ion-exchange chromatography. Using the partially purified PKC, the phosphorylation of PKC substrates was examined in vitro. The phosphorylation of the 80 kDa protein was enhanced by phorbol ester treatment in vitro as well as in vivo. The partial amino acid sequence of this protein was homologous with that of guanosine 5'-cyclic monophosphate (cGMP)-dependent protein kinase and myosin light chain kinase, both of which are related to ligand-receptor-transduction. The present data suggest that the activation of PKC and subsequent specific protein phosphorylation might be involved in the regulation of the zona pellucida-induced acrosome reaction.
Equinatoxins were purified from the tentacles and bodies of the sea anemone Actinia equina by the use of acetone precipitation, as well as column chromatographies on Sephadex G-50 and CM-cellulose according to the modified method of Macek and Lebez (1988). The equinatoxins obtained, equinatoxin 1 and 2, were hemolytic glycoproteins with a relative molecular mass of 20000. Equinatoxin 2 was found to be rich in glycine, alanine and valine. The amino acid sequences of equinatoxins 1 and 2 were partially determined. A portion of the N-terminal amino acid sequence of equinatoxin 2 was similar to those of pyruvate kinase and sialidase.
To clarify the differences in characteristics between participants and non-participants in the screening program for stomach cancer, life-style and medical histories were compared among 20, 169 subjects who lived in an urban area (Sendai) and a rural area (Wakuya and Tajiri) in Miyagi Prefecture, Japan. All subjects were classified into three groups according to the frequency of participation in the screening program during the last 5 years; i.e., frequent participating group (FPG) for 4 or 5 times, reference group (RG) for 1-3 times and non-participating group (NPG) for 0 times. Subjects in the FPG consumed more milk and green-yellow vegetable whereas those in the NPG consumed less these foods. The age-adjusted proportions of present smokers were higher in the NPG but lower in the FPG significantly. The proportions of subjects who had parental histories of all cancers and stomach cancer and past history of gastro-duodenal ulcer were higher in the FPG and lower in the NPG. To control influences among the variables a stepwise multiple regression analysis was done, and it revealed that smoking and parental history of cancers were strong predictors to explain the frequency of participation.
Manipulating two types of Japanese Kana script, Katakana and Hiragana, we examined the effects of a script change between study and test on later word-fragment completion. Throughout three experiments, materials were composed of foreign loan nouns normally written in Katakana, but not in Hiragana, according to approved usage in Japanese. Experiment 1 demonstrated the reliable size of cross-script priming between Katakana and Hiragana. In Experiment 2, cross-modal priming was substantial when modality of presentation was changed from auditory to visual. In Experiment 3, generating a target word from its definition induced priming comparable in size to that in the prior reading condition. These results have been confirmed in the Hiragana test, as well as in the Katakana test, thereby suggesting that some conceptual and modality-independent processes may also mediate repetition priming.
The early and long-term results of both surgical and nonsurgical therapy for 160 patients with acute aortic dissection in our institution were analyzed. Of the 83 patients with acute type A aortic dissection, 47 received surgery during acute stage, 10 received it in the chronic stage, and 26 received nonsurgical therapy. Of the 77 patients with acute type B aortic dissection, 27 received surgery during acute stage, 22 received it in the chronic stage, and 28 received nonsurgical therapy. Ten-year survival rates for patients receiving surgery during the acute stage were 62% for type A and 64% for type B dissection. This survival rate for type A patients was significantly higher than that for type A patients not receiving surgery, but the corresponding difference for type B patients was not significant. Present data indicate that immediate surgical intervention is indicated in patients with acute type A dissection, and elective operation in the subacute stage in patient with uncomplicated type B dissection following medical therapy in the acute stage.
The purpose of this experiment was to observe and measure the distribution of heat to bones and the maximum temperature that developed when cutting bone with drills. Generation of heat that spread in the presence or absence of irrigation when drilling with IMZ, Brånemark, and ITI implant (F type) drills was observed in the pig rib via thermography. Without irrigation, the condition of heat spread in each drill and bur differed according to bur shape and drilling site. Maximum heat temperature without irrigation was higher than that with irrigation for any IMZ, ITI, and Brånemark drill.
A total of 238 patients undergoing resection of lung cancer were studied for the occurrence of postoperative arrhythmia. Transient arrhythmia was observed in 43 of them (18.1%). Ninety-one percent of 43 patients developed atrial fibrillation (Af), even though no arrhythmia was noted on ECG in any patient preoperatively. Cardiac dysrhythmia occurred 5.2 +/- 3.8 days after operation and lasted for 1.3 +/- 0.9 days (mean +/- SD). There was a significant difference (p less than 0.05) in the incidence of postoperative arrhythmia between the male group (39/188 = 21%) and the female group (4/50 = 8%), however the cause of a difference is unknown. The incidence was higher in patients undergoing pneumonectomy than in those undergoing lobectomy. Patients, who suffered from postoperative arrhythmia, has significantly low values on pulmonary function test (FEV1.0% = 68.7%) preoperatively. The increased cardiac load after the reduction of the pulmonary vascular bed was regarded as the most important factor of arrhythmia. Prophylactic administration of digoxin was performed in another 61 male patients after resection of lung cancer. And it was found to be effective in decreasing the incidence of postoperative atrial fibrillation (5/61 = 8%).
In this study, we report the effect of selective perfusion to the visceral arteries during aortic cross-clamping at surgery for thoracoabdominal aortic aneurysms with an adjunct of femoro-femoral (F-F) extracorporeal bypass. The total series comprising 28 patients were divided into 3 groups according to the perfusion mode to the celiac and the renal arteries, i.e., group I; the arteries were continuously perfused by the extracorporeal bypass, group II; aortic cross-clamp excluded the branches from the bypass flow but selective perfusion was employed, and group III; the liver or the kidneys were subjected to ischemia. As a result, group III developed hepatic failure at the incidence of 50% which was characterized by hepatocellular damage followed by cholestatic dysfunction. As for postoperative renal function, this group revealed persistently high level of serum creatinine, and 60% of this series resulted in renal failure. On the contrary, group II showed a comparable effect to group I on the preservation of hepato-renal function, and there were no differences in the incidence of hepatic or renal failure between the two groups. Multiple organ failure was a predominant cause of hospital death, and it developed only in the cases with aortic cross-clamp time more than 90 minutes. However, avoiding ischemia achieved in group I or II significantly reduced the incidence of MOF and its related deaths. It is concluded that selective perfusion system incorporated with an aid of F-F partial bypass was a useful measure to protect vulnerable organs from ischemia and to reduce postoperative mortality and morbidities.
We evaluated the residual false lumen of type I and IIIb dissecting aneurysm by CT, MRI and angiography postoperatively. The 19 patients with type I dissecting aneurysm were included eleven men and eight women, the average age was 55.8 +/- 10.2 years old. The 20 patients with type IIIb dissecting aneurysm were included sixteen men and four women, the average age was 56.2 +/- 8.5 years old. The rate of distal patent false lumen was 52.6% of type I and 35% of type IIIb dissecting aneurysm after graft replacement surgery. In type I dissecting aneurysm, the rate of distal patent false lumen was 40% of acute stage vs 66.7% of chronic stage, 66.7% of ascending and partial arch replacement vs 46.2% of ascending and total arch replacement, and 90% of graft inclusion technique vs 11.1% of graft exclusion technique. The distal patent false lumen was the lowest (12.5%) with type I dissecting aneurysm of ascending and total arch replacement using graft exclusion technique. In type IIIb dissecting aneurysm, the rate of patent false lumen was 66.7% of acute stage vs 29.4% of chronic stage, 30% of graft exclusion technique vs 40% of graft inclusion technique. The size of false lumen preoperatively were larger (11.1 +/- 4.5 cm2) in patients with distal patent false lumen than that (6.7 +/- 3.2 cm2) of in patients with distal occlusive false lumen.(ABSTRACT TRUNCATED AT 250 WORDS)
Forty-seven patients who underwent coronary artery bypass grafting using blood cardioplegia (BCP) were studied clinically. They were divided into 3 groups based on concentration of diltiazem (DTZ) and nitroglycerin (NTG). Group I (n = 12); DTZ 5 mg plus NTG 5 mg in BCP 1,000 ml, Group II (n = 10); NTG 25 mg in BCP 1,000 ml, Group III (n = 25); DTZ 5 mg plus NTG 25 mg in BCP 1,000 ml. From the standpoint of serum enzyme analysis, there was no significant difference between 3 groups, however, the incidence of perioperative myocardial infarction (PMI) and perioperative coronary spasm (PCS) were significantly higher in Group I than that in other groups. The present data suggests that intramyocardial concentration of NTG in Group II and III were 5 times higher than Group I. Increased dose of NTG in BCP would be benefit for myocardial protection in CABG.
To assess the risks of leukemia for individuals participating in a gastric mass screening program using barium photofluorographic examination in Japan, a population-based, case-control study was carried out. The histories of participation in the last 10 years of 79 leukemia cases diagnosed between 1978 and 1985 and twofold controls matched for sex, age (+/- 5 years), and residence were investigated using the records of the gastric mass screening program. The odds ratio of any type of leukemia for those participating at least once in the last 10 years was 1.09 (95% confidence interval, 0.61-1.96) and that of myeloid type was 0.88 (95% confidence interval, 0.38-2.27). Even when the histories of the preceding 5 years were ignored, no significant excess risks were found among patients with any type and myeloid type of leukemia. These results suggest that there is insufficient evidence to support the positive association between the incidence of leukemia and participation in gastric mass screening. The limitations and implications of this analysis are discussed.
Between April 1988 and February 1992, eight patients with type A aortic dissection associated with annuloaortic ectasia (AAE) underwent the concomitant graft replacement of the total aortic root and the transverse aortic arch at our institution. The acuity of the aortic dissection was acute stage in 3 patients and chronic stage in 5 including 3 cases of re-do operation. All operations were performed with an aid of extracorporeal circulation, blood cardioplegia, selective cerebral perfusion and open distal anastomosis. The operative techniques employed in this series consisted of total aortic root replacement using a composite graft (Bentall, Cabrol or Piehler's technique), and total arch replacement using en bloc arch reconstruction or three vessels graft replacement. One patients underwent re-do operation for coronary anastomotic false aneurysm following Bentall operation and aneurysmal dilatation of the false lumen at the aortic arch, and died of LOS because of the prolonged myocardial ischemia. Other seven patients survived the operation, and lead the normal life at the present time. The present data suggests that type A aortic dissection associated with AAE involving aortic arch could be treated by concomitant graft replacement of the total aortic root and the transverse aortic arch.
Between March 1991 and August 1991, six consecutive patients underwent the replacement of the both ascending aorta and total aortic arch using a prosthetic graft with three branches for acute type A aortic dissection involving the aortic arch. Preoperative complications included cardiac tamponade in 5 cases, aortic regurgitation in 2, and shock state in 3. All operations were performed with the aid of extracorporeal circulation, selective cerebral perfusion, and open aortic anastomosis within 3 days after the onset. One patient died of rupture of the aortic anastomosis secondary to mediastinitis two weeks after the operation. All patients gained their own consciousness after the operation without any serious cerebral complications. The present data suggest that acute type A aortic dissection involving the aortic arch could be treated by replacing both the ascending aorta and aortic arch using a prosthetic graft with three branches with an aid of the extracorporeal circulation, selective cerebral perfusion and open distal anastomosis.
We report 14 consecutive patients who have undergone ReCABG during the last 7 years (1984-1990). There were 11 males and 3 females with a mean age of 56.8 years. All bypass conduits used were saphenous vein grafts. Angiographic indications for ReCABG included primary bypass graft failure, progressive coronary arteriosclerosis, and both of them. Successful ReCABG is mainly dependent on careful attention to special surgical technical considerations such as heart exposure especially in the existence of functioning bypass graft, cardiopulmonary bypass technique and myocardial protection and choice of available bypass conduits. We used arterial grafts in 6 cases (ITA in 4 and GEA in 2 cases). There was only one hospital mortality in our series. Symptomatic relief of angina pectoris was obtained in all surviving patients.