Biomedical subjects

S Ohgi

Publications and source records attributed to S Ohgi.

At least 37 records · Page 2Linked to original sources

PubMed2000

Percutaneous balloon fenestration in a case of traumatic abdominal aortic dissection with lower extremity ischemia.

A 38-year-old man was involved in a traffic accident and experienced a heavy blow to the abdomen. He had traumatic abdominal aortic dissection with right lower extremity ischemia. He underwent percutaneous balloon fenestration, which is safe and minimally invasive, for relief of right lower extremity ischemia. He has been working for 2 years without any signs of vascular compromise. Percutaneous balloon fenestration is one of the few treatments for traumatic abdominal aortic dissection.

Abdominal Injuries↗

PubMed2000

Allele frequency of human endothelial nitric oxide synthase gene polymorphism in abdominal aortic aneurysm.

OBJECTIVE: This study was performed to examine the role of the endothelial constitutive NO synthase (ecNOS) gene in patients with abdominal aortic aneurysm (AAA). METHODS: We determined the distributions of polymorphism in intron 4 of the ecNOS (ecNOS4) gene, amplified by polymerase chain reaction, and compared the allele frequencies between subjects with abdominal aortic aneurysms (AAAs) and healthy individuals. PATIENTS: Fifty-eight patients with AAAs and 410 race-matched healthy controls were studied. RESULTS: Two alleles of the ecNOS4 gene, containing 4 (a-allele) and 5 (b-allele) repeats, were identified. We found that the a-allele frequency of this gene was significantly higher in the surgical than in the non-surgical group. CONCLUSION: The results of this study suggest that the a-allele of the ecNOS4 gene is indicative of the need for surgery for AAA. Analysis of the alleles of the ecNOS4 gene polymorphism could provide useful information concerning the clinical course of AAA progression.

Aged↗

PubMed2000

[Video-assisted thoracic surgery (VATS) for metastatic lung tumor: comparison with thoracotomy].

Effectiveness and present problems of video-assisted thoracic surgery (VATS) for metastatic lung tumor were investigated by comparing 14 cases (16 operations) of VATS with 16 cases (19 operations) of conventional thoracotomy during the same period. VATS was favorably selected in the solitary metastasis. The cases who had small tumor diameter less than 3 cm and shorter distance from viseral pluera to the tumor surface than tumor diameter were advantageous for only thoracoscopic procedure to do the safe and sure resection. Regarding to the tumor number, we detected another tumor intraoperatively in 2 of 16 cases (12.5%) of VATS and 6 of 19 cases (31.6%) of thoracotomy. Multiple metastases had the tendency to have the differences of the tumor number between preoperation and intraoperation. Prognosis is very good until now, but the recurrence rate was high (64.5%) and one case had the recurrence at the surgical margin. VATS for metastatic tumor is very effective, but it is important not to hesitate to do the mini-thoracotomy and convert to conventional thoracotomy for safe and sure resection.

Adult↗

PubMed2000

[Coronary artery bypass grafting for a patient with bronchial asthma seceeded from cardiopulmonary bypass by additional bypass for spasm of radial artery graft: a case report].

A 78-year-old male who had a bronchial asthma underwent coronary artery bypass grafting (CABG) using the left internal thoracic artery and the radial artery. The patient could not be weaned from the cardiopulmonary bypass because the radial artery which anastomosed to the obtuse marginal artery (OM) had a spasm after CABG. An additional bypass using a long saphenous vein to OM was carried out immediately. It brought a weaning from cardiopulmonary bypass. If the cardiac function after CABG is insufficient in patients with bronchial asthma, CABG must be re-done immediately, considering that they cause the arterial spasm more than patients without bronchial asthma.

Aged↗

PubMed2000

[A new method of reconstruction for chest wall resection].

Sixteen patients who involved in chest wall disease underwent major chest wall resection between April 1995 and January 1999. The underlying diseases were 6 recurrence of breast cancers, 4 direct invasion by primary lung cancer, 2 metastatic chest wall tumor, one direct invasion by metastatic lung tumor, one direct invasion by metastatic mediastinal tumor, one radio-induced-necrosis of the chest wall, and one chest wall infection. In 9 patients, the thoracic cage reconstruction was performed using double sheets of absorbable mesh (Dexon mesh), cross string sutures and autologous ribs grafts. None of the patients had major respiratory failure and chest wall unstability. No late complications including infections, pains, recurrence and others related to reconstruction materials have been observed.

Aged↗

PubMed2000

[Thoracoscopic surgery for pulmonary nodules in patients with previous malignant tumor].

We evaluated the clinico-pathological characteristics of thirty-four cases with previous malignant tumor who was operated under thoracoscopy for pulmonary nodules. In twenty-three cases (67.6%), including 20 cases suspected metastatic pulmonary tumor before operation, thoracoscopic surgery was performed without doing the preoperative examinations for the definite diagnosis. The mean diameter of resected tumors was 13.5 mm and the definite diagnosis was determined in all cases by the intraoperative pathological diagnosis. There were 26(76.5%) cases of malignancy, including 20 cases(58.8%) of metastatic pulmonary tumor and 6 cases (17.7%) of primary lung cancer. Accuracy rate of predictive diagnosis before operation was 67.6%. From the analysis of difference between pre- and post-operative diagnoses, inflammatory nodules or tuberculoma in the solitary nodule and intrapulmonary lymph nodes or silicotic nodules in the multiple nodules should have been considered with more carefully attention. Univariate and multivariate analysis showed that patients with metastatic tumor previously was only a predictive factor for metastatic tumor. Age, gender, CT findings, the number of nodules, disease free interval and tumor markers were unreliable factors in this study. In conclusion, there were a lot of cases with previous malignant tumor in which thoracoscopic surgery could become a first choice of modalities for the diagnosis of pulmonary nodules. Early thoracoscopic procedure will be recommended for such patients to perform the immediate treatment.

Adolescent↗

PubMed2000

Permanent cardiac pacing following surgery for acquired valvular disease.

Between January 1980 and January 1998, implantation of a permanent pacemaker (PP) was performed in 22 patients (6.7%) following 327 acquired valvular surgeries. The indications for implantation of a PP were bradycardia with atrial fibrillation in 12 cases, sick sinus syndrome in 7 cases and complete atrioventricular block in 3 cases. These patients received an implantation after surgery for mitral valvular disease in 14 cases, aortic valvular disease in 3 cases and combined valvular disease in 5 cases. These cases were also concomitant with a tricuspid valve annuloplasty in 6 cases for secondary regurgitation and with a maze procedure in 4 cases. For the purpose of this study, these patients were compared to patients who did not require implantation of a PP after surgery. Univariate analysis showed the significant factors to be female gender (p = 0. 041), preoperative atrial fibrillation (p = 0.013), redo cardiac surgery (p < 0.0001), and the use of blood cardioplegia (p = 0.003). There were no differences in valvular disease, age at the last valvular operation, addition of tricuspid valve annuloplasty, extracorporeal circulation times, or aortic cross-clamp times between those patients with and those without PP. Among these factors, logistic regression analysis showed female gender, redo surgery and the use of blood cardioplegia to be more significant predictors for the requirement of PP after acquired valvular disease operation. Maze procedure was not a significant predictor for the requirement of PP after surgery.

Adult↗

PubMed2000

Thoracoscopic debridement for acute pediatric empyema: efficacy of ultrasonic surgical device.

Few studies have examined thoracoscopic treatment for pediatric empyema. We encountered three children with thoracic empyema successfully treated by thoracoscopic debridement. Patients were a 3-year-old girl, a 17 month-old boy and a 13-year-old girl who developed thoracic empyema during therapy for pneumonia. We performed dissection and debridement under thoracoscopy and resolved fibrinopurulent collections using an ultrasonic surgical device in two cases to search the dissection plane while minimizing injury to the lung parenchyma. Ultrasonic surgical device (USUTM) is very useful for performing effective debridement and irrigation with minimal pleural damage. Thoracoscopic debridement performed early in the course of therapy is recommended even for acute pediatric empyema and could prevent the unnecessary open surgical intervention or decortication.

Acute Disease↗

PubMed1999

Lung carcinoma: analysis of T helper type 1 and 2 cells and T cytotoxic type 1 and 2 cells by intracellular cytokine detection with flow cytometry.

BACKGROUND: T helper type 1 cells (Th1), Th2, T cytotoxic type 1 cells (Tc1), and Tc2 play important immunoregulatory roles. Some recent studies have demonstrated that an elevated level of type 2 cytokines, such as interleukin-10, contributes to the ability of cancer cells to escape immunosurveillance. However, the impacts of Th1, Th2, Tc1, and Tc2 on tumor immunity are unclear. METHODS: The authors evaluated the ratio of Th1 to Th2 and that of Tc1 to Tc2 among peripheral blood lymphocytes (PBL), regional lymph node lymphocytes (RLNL), and tumor-infiltrating lymphocytes (TIL) in 46 nonsmall cell lung carcinoma patients who had just undergone surgery; the evaluation involved detecting the intracellular interferon-gamma and interleukin-4 production with 3-color flow cytometry. They also evaluated the same ratios in the peripheral blood lymphocytes of 29 lung carcinoma patients with or without recurrence after surgery, and in the peripheral blood of normal volunteers. RESULTS: The Th1-to-Th2 and Tc1-to-Tc2 ratios were significantly elevated in the tumor tissues. These ratios in the TIL were significantly elevated in the groups of patients with squamous cell carcinoma and a history of smoking. The Th1-to-Th2 and Tc1-to-Tc2 ratios were significantly depressed in the PBL of the patients with tumor recurrences. CONCLUSIONS: A favorable Th1- and Tc1-dominant pathway is induced in the tumor tissues of operable patients, but their pathway can be expected to shift from Th1 or Tc1 to Th2 or Tc2 with the progression of cancer.

Adenocarcinoma↗

PubMed1999

The advantages of normocalcemic continuous warm cardioplegia over low calcemic cardioplegia in myocardial protection.

The effects of changing the calcium content of a continuous warm hyperkalemic crystalloid cardioplegia (CWCP) were investigated in an isolated rat heart preparation. The hearts were divided into eight groups of six each. A control group consisted of fresh nonarrested hearts and the remaining seven groups consisted of hearts perfused with continuous hyperkalemic (20 mM) modified Krebs-Henseleit bicarbonate buffer solution with calcium concentrations of 0.1, 0.3, 0.5, 1.0, 1.5, 2.0, or 2.5 mM, for either 180 or 240 min at 37 degrees C. In the hearts arrested for 180 min, there were no significant differences in postarrest cardiac functions between the control group and any of the groups perfused with calcium concentrations of 0.5 mM or more. With a calcium concentration of 0.1 mM, the calcium paradox was provoked. The change in the calcium content of CWCP perfused for 240 min significantly affected myocardial protection. Maximum aortic flow recovery, of 74.7% +/- 2.7%, and minimum CK release, of 15.7 +/- 2.4 IU/15 min/g dry weight, were observed in hearts perfused with a calcium concentration of 1.5 mM. The calcium paradox occurred even at a calcium concentration of 0.3 mM; therefore, normal calcium concentrations should be maintained in cardiac surgery to prevent cardiac injury.

Animals↗

PubMed1999

Risk of low calcium and high magnesium in continuous warm hyperkalemic cardioplegia.

BACKGROUND: The recent introduction of operations on a warm heart has prompted clinical reports on the usefulness of continuous blood cardioplegia, but no in-depth basic evaluation of continuous cardioplegia has been done. The cardioprotective effects of magnesium (Mg) and calcium (Ca) in continuous warm hyperkalemic crystalloid cardioplegic solutions were investigated in an isolated rat heart model. METHODS: Isolated rat hearts were arrested for 180 minutes at 37 degrees C with a continuous warm hyperkalemic (20 mmol/L) modified Krebs-Henseleit bicarbonate buffer solution containing 1.2, 8.0, or 16.0 mmol/L of Mg and 0.1 to 2.5 mmol/L of Ca in different concentrations. Recovery of cardiac function and tissue damage were estimated. RESULTS: For each Mg concentration, the percentage recovery of aortic flow generated dose-response curves depending on Ca concentration. However, as Mg concentration increased, the recovery of aortic flow decreased in the groups with 0.5 mmol/L of Ca or less. CONCLUSIONS: In continuous warm cardioplegia the combination of low Ca and high Mg concentration caused severe cardiac injury, and normal Ca concentration avoids cardiac injury regardless of Mg concentrations.

Animals↗

PubMed1999

Thrombosed dissection of the ascending aorta complicating extravasation.

This report presents 2 patients with thrombosed dissection of the ascending aorta complicating extravasation. The first case was an 85-year-old male admitted with shock due to cardiac tamponade. Plain computed tomography (CT) demonstrated a dilated ascending aorta without clear evidence of aortic dissection. The second case was a 77-year-old female presenting with shock, in whom an enhanced CT scan demonstrated a dilated ascending aorta and periaortic effusion. However, dissection of the distal ascending aorta was not identified in either case before emergency surgery. In case 1, soon after the bloody pericardial effusion was decompressed during the operation, bleeding from the ascending aorta occurred. A small intimal tear was found in the distal ascending aorta, and in each case the pseudolumen was filled with fresh thrombus. The ascending aorta was replaced. Each patient had an uneventful postoperative recovery. Based on this experience, it is suggested that patients with thrombosed ascending aortic dissection complicating extravasation should undergo early graft replacement.

Aged↗

PubMed1999

Thoracoscopic surgery for intralobar pulmonary sequestration.

A 47-year-old male with intralobar pulmonary sequestration successfully treated by thoracoscopic surgery was reported. Preoperative selective angiography revealed two aberrant arteries originating from the left infraphrenic artery. Under thoracoscopy, adhesive tissues around the sequestered lung were dissected, aberrant arteries were divided and the sequestered lung was resected. We considered that preoperative detailed analysis of the aberrant artery was very important to safely perform thoracoscopic procedures for pulmonary sequestration.

Angiography, Digital Subtraction↗

PubMed1998

Effects of mutations in residues near the active site of human immunodeficiency virus type 1 integrase on specific enzyme-substrate interactions.

The phylogenetically conserved catalytic core domain of human immunodeficiency virus type 1 (HIV-1) integrase contains elements necessary for specific recognition of viral and target DNA features. In order to identify specific amino acids that determine substrate specificity, we mutagenized phylogenetically conserved residues that were located in close proximity to the active-site residues in the crystal structure of the isolated catalytic core domain of HIV-1 integrase. Residues composing the phylogenetically conserved DD(35)E active-site motif were also mutagenized. Purified mutant proteins were evaluated for their ability to recognize the phylogenetically conserved CA/TG base pairs near the viral DNA ends and the unpaired dinucleotide at the 5' end of the viral DNA, using disintegration substrates. Our findings suggest that specificity for the conserved A/T base pair depends on the active-site residue E152. The phenotype of IN(Q148L) suggested that Q148 may be involved in interactions with the 5' dinucleotide of the viral DNA end. The activities of some of the proteins with mutations in residues in close proximity to the active-site aspartic and glutamic acids were salt sensitive, suggesting that these mutations disrupted interactions with DNA.

Binding Sites↗

PubMed1998

Pulmonary embolism in patients with isolated soleal vein thrombosis.

This study investigated the features of calf deep vein thrombosis (DVT) as a pulmonary embolic source. Fifty-eight lower limbs in 29 patients who were suspected of having DVT distal to the popliteal vein were screened by ultrasonography. Then, ascending venography was performed to confirm the diagnosis. Pulmonary embolism (PE) was diagnosed in suspected patients by use of pulmonary perfusion scanning or pulmonary angiography. Venography revealed calf DVT in 33 limbs in 28 patients. Of 28 patients, six had symptomatic PE. Thrombosis was found in the muscle veins in 18 limbs, the trunk veins in 11, and both veins in four. Isolated single vein thrombosis was found in the soleal vein in 14 limbs (42%), the posterior tibial vein in eight, the peroneal vein in two, and the gastrocnemius vein in two. The overall percentage of soleal vein thrombi was 61%. All six patients with symptomatic PE had isolated soleal vein thromboses. Calf DVT was a pulmonary embolic source when isolated thrombosis of the large soleal vein was more than 7 mm in diameter. Soleal veins were the most frequent and important location of calf DVT, suggesting that these were an occasional embolic source of critical PE.

Aged↗

PubMed1996

Glucose modulates growth of gingival fibroblasts and periodontal ligament cells: correlation with expression of basic fibroblast growth factor.

Diabetes mellitus is a systemic disease with profound effects on oral health and periodontal wound healing. Uncontrolled diabetes adversely affects surgical wound healing and is often associated with abnormal proliferation of fibroblasts, excessive angiogenesis and poor bone regeneration. Human gingival fibroblasts and periodontal ligament cells from both diabetics and non-diabetics were evaluated for growth responses following culture in 20 mM glucose, a concentration compatible with blood glucose levels in uncontrolled diabetics. Gingival fibroblasts derived from 9 non-diabetic patients and 3 insulin-dependent diabetics either proliferated or showed little change of growth in elevated glucose. Enhanced proliferation was observed following 1 wk of culture in glucose. Growth of periodontal ligament cells from 5 non-diabetic patients was inhibited by 20 mM glucose. Fibroblasts that were markedly growth stimulated were probed for expression of basic fibroblast growth factor (bFGF) using a reverse-transcribed polymerase chain reaction (RT-PCR). Results indicate that fibroblasts exhibiting the greatest increase in growth in response to high glucose also exhibited increased expression of bFGF. No changes were observed in mRNA expression for platelet-derived growth factor-AA, platelet-derived growth factor-BB, insulin-like growth factor and transforming growth factor-beta 1. Mitogenic effects induced by the cytosol of fibroblasts exhibiting increases of growth in 20 mM glucose were abrogated by neutralizing antibodies to bFGF. In addition, some periodontal ligament cells that were growth inhibited by high glucose had reduced expression of bFGF. These data suggest that bFGF may play a role in the abnormal wound healing associated with periodontal surgery of uncontrolled diabetics.

Antibodies↗

PubMed1993

Bactericidal effects of povidone-iodine solution to oral pathogenic bacteria in vitro.

Seven species of periodontal pathogenic bacteria (Bacteroides, gingivalis, Bacteroides intermedius, Bacteroides melaninogenicus, Fusobacterium nucleatum, Actinobacillus actinomycetemcomitans, Capnocytophaga spp., Eikenella corrodens) and two control species (Streptococcus intermedius, Pseudomonas aeruginosa) were selected in order to study the bactericidal effects of 10% povidone-iodine (PVP-I) aqueous solution in vitro. The PVP-I solution was diluted to 10, 20, 50, 100, 200, 400, 800, 1600, 3200, 6400 and 12800 x and contact times were 15, 30 and 60 seconds. The strongest bactericidal effects on the seven periodontal pathogenic bacteria and two control bacteria were seen at a dilution of 400 x and a contact time of 15 seconds. Based on these findings, we advocate a 0.25% solution of 10% aqueous PVP-I for oral mucosa and periodontal pocket irrigation.

Aggregatibacter actinomycetemcomitans↗

PubMed1991

A new hereditary abnormal protein C (protein C Yonago) with a dysfunctional Gla-domain.

A familial abnormal protein C most probably with the dysfunctional Gla domain was found in a 60-year-old man with recurrent thrombosis. Namely, the anticoagulant activity as measured by the APTT method and the antigen level by an ELISA utilizing a calcium-dependent antibody were reduced to nearly half of normal, 43.5% and 2.1 micrograms/ml (normal range: 2.8-5.0 micrograms/ml), respectively. On the other hand, the amidolytic activity determined on a synthetic chromogenic substrate, S-2366, and the total antigen measured by an ELISA utilizing a polyclonal antibody were both in the normal range, 74.1% and 83% of normal, respectively. Crossed immunoelectrophoresis showed more anodal migration than the normal control in the presence of calcium ions, and adsorption of protein C to barium citrate was insufficient. These data altogether indicated that a half population of protein C in the patient's plasma was dysfunctional in the Gla domain or its related structures. Four other members of his immediate family were found to have the same abnormality of protein C, although they had been all asymptomatic. We thus conclude that the dysfunctional protein C is hereditary, and that the abnormalities noted in several tests are most likely due to a structural defect residing in the Gla or its related regions. We hereby designate this abnormal protein C as protein C Yonago.

Blood Coagulation Tests↗