Urbanization and population distribution policies in Japan.
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Asia↗
Biomedical subjects
T Kuroda
Publications and source records attributed to T Kuroda.
[Coronary spasm during laryngoplasty].
A 63-yr-old man weighing 56kg was scheduled for pharyngoplasty under general anesthesia. The patient had no history of ischemic heart disease. Preoperative ECG showed incomplete right branch block. We administered thiopental and succinylcholine for intubation. Anesthesia was maintained with enflurane, nitrous oxide, oxygen and pancuronium bromide. Thirty minutes after the start of incision, the patient developed a severe hypotension and ECG revealed ST elevation and complete AV block. We administered ephedrine hydrochloride, phenylephrine hydrochloride and atropine sulfate. The ECG returned to sinus rhythm but ST segment was depressed this time. We considered it due to coronary spasm, so we started continuous intravenous administration of nitroglycerin (0.5 microgram. kg-1. min-1). One hour later, ST segment returned to normal. ECG showed no remarkable changes and no symptoms were seen after the operation. We found it important to suspect coronary spasm when ECG showed PVC-like abnormal waves with ST elevation. We consider that continuous administration of nitroglycerin at a rate of 0.5 microgram. kg-1. min-1 was effective for the treatment of coronary spasm in this case.
Coronary Vasospasm↗
Limited proteolysis of protein kinase C subspecies by calcium-dependent neutral protease (calpain).
Limited proteolysis of three distinct subspecies of protein kinase C (Ca2+/phospholipid-dependent enzyme, PKC), types I (gamma), II (beta I and beta II), and III (alpha), with Ca2+-dependent neutral proteases I and II (calpains I and II) was studied. All forms of PKC (82 kDa) were converted to two major fragments: a 45-49-kDa catalytic fragment and a 36-kDa regulatory fragment. The cleavage of these PKC subspecies by calpain I (active in the micromolar range Ca2+/ion concentration), and, to a lesser extent, by calpain II (active in the millimolar range), was enhanced by the simultaneous presence of phospholipid and diacylglycerol or phorbol ester, suggesting that the activated form of PKC is the preferred target for proteolysis. Analysis of the NH2-terminal sequence of the resulting catalytic fragments indicated that both calpains I and II cleave at one or two specific sites in the third variable region (V3) of each PKC molecule. Under comparable conditions with calpains I and II, the relative rates of cleavage of types I, II, and III PKC were approximately 100:16:2 and 100:48:23, respectively. The results imply that within the cell various PKC subspecies may be cleaved at different rates under different physiological conditions.
Amino Acid Sequence↗
Studies on the rectoanal reflex in children and in experimental animals: an evaluation of neuronal control of the rectoanal reflex.
A single-chamber pressure probe for rectal electromanometry was developed which seems to be superior to the complicated multichamber systems not only for clinical but also for experimental purposes. Measurements of rectoanal reflex were carried out in 268 cases with abnormal bowel function, in 103 cases following operation for Hirschsprung's disease, and in 61 cases of imperforate anus to assess postoperative continence. Experimental studies were performed in 36 dogs, 27 of which were used for short-term and 9 for long-term studies. The results of clinical and experimental studies are described and discussed, with accompanying literature. From clinical and experimental studies, the neuronal pathways of the rectoanal reflex are schematized. The normal rectoanal reflex is mediated by both the sacral cord and the myenteric neurons. It is concluded that measurements of the anal resting pressure and the rectoanal reflex constitute a valuable method to distinguish between normal and pathological sacral and myenteric innervation.
Anal Canal↗
Problems in diagnosis of Hirschsprung's disease by anorectal manometry.
The purpose of this study is to analyze the results of anorectal manometry and to evaluate the merits and disadvantages of this technique for the diagnosis of Hirschsprung's disease. Studies were performed in 268 patients with constipation, including 95 cases of Hirschsprung's disease. It is concluded from the results that Hirschsprung's disease can be confidently diagnosed by manometric studies. If the studies are performed carefully with a suitable probe, reliability is over 95%. Manometry is the most useful method to differentiate Hirschsprung's disease from other conditions, such as extremely short segment aganglionosis, colonic stenosis, and idiopathic megacolon.
Adolescent↗
Perioral force measurement by a radiotelemetry device.
A telemetric method was developed to monitor the active and passive perioral forces exerted on the maxillary dental arch. The system consists of intraoral and extraoral units. An electromagnetic coupling between intraoral and extraoral coils supplies the power of the intraoral unit and transmits the signals induced by variations in perioral forces. The force sensor has a diameter of 6 mm, a thickness of 1 mm, and is constructed of an 0.08 mm thick cantilever beam to which semiconductor strain gauges are cemented. Clinical application of the system was tested in four adult subjects. The forces on the labial surface of an upper central incisor were 1.5 gm/cm2 during rest, 10.9 gm/cm2 during swallowing, and 5.0 gm/cm2 during speech; the corresponding lingual forces were 4.0 gm/cm2, 19.1 gm/cm2, and 13.9 gm/cm2, respectively. Lingual forces were always higher than labial forces. The telemetry system can be used to monitor up to 6 hours of continual variations in perioral forces.
Adult↗
Involvement of endogenous prostaglandins in pancreatic endocrine and exocrine secretion in dog pancreas.
The involvement of endogenous prostaglandins (PGs) in pancreatic endocrine and exocrine secretion was investigated, using the isolated and perfused dog pancreas. Spontaneous production of both PGE2 and 6-keto-PGF1 alpha was recorded in venous effluent. Prostaglandin production increased following stimulation with both 10 x 10(-11) and 20 x 10(-11) mol of CCK-8, but was not affected by a 5 x 10(-11) mol infusion. Insulin, glucagon, and amylase release was stimulated by 10 x 10(-11) mol of CCK-8. Indomethacin pretreatment with 10 mg/kg totally abolished endogenous PG production, but failed to suppress an insulin and glucagon response. On the other hand, an amylase response was accelerated by indomethacin pretreatment. Although low dose CCK-8 failed to stimulate endogenous prostaglandin production, a brisk exocrine secretion was not suppressed by indomethacin pretreatment. From the above results, we conclude that endogenous PGs do not appear to play an important role in pancreatic endocrine and exocrine secretion, but might have a cytoprotective effect on the pancreatic acinar cells damaged by CCK-8.
Amylases↗
Leukocyte-poor platelet concentrates at the bedside by filtration through Sepacell-PL.
We developed a new filter, 'Sepacell-PL', consisting of a blood administration set for the preparation of leukocyte-poor platelet concentrates at the patient's bedside. This filter is packed with 1.8 microns polyester fibers coated with a new polymer, and has a volume of 14 ml. Sepacell-PL removed more than 99% of the leukocytes while approximately 93% of platelets were recovered from 10 units of platelet concentrates which contained 5 x 10(8) leukocytes and 3 x 10(11) platelets. The functions of pre- and postfiltrated platelets were unchanged. The filtration procedure is very simple, without priming with saline to remove air and wet the filter. Moreover, platelet concentrates can be passed through the filter at a flow rate of 4 ml/min, or at a higher flow rate of 54 ml/min by gravity.
Blood Transfusion↗
Mullerian inhibiting substance in the adult rat ovary during various stages of the estrous cycle.
Mullerian inhibiting substance (MIS) in the adult rat ovary can be detected by immunohistochemistry in the granulosa cells of growing preantral follicles and in the cumulus oophorus and periluminal granulosa cells of antral follicles in estrus, metestrus, diestrus, and proestrus. Neither the corpus luteum nor atreitic follicles stained for MIS. During proestrus, dramatic changes occurred in the large preovulatory antral follicles, which early in the day manifest intense MIS-specific staining in the granulosa cells located close to the oocyte, however, at 2300 h, just before ovulation when the germinal vesicle was extruded to indicate resumed meiotic division, MIS staining waned. When the morphology of the late preovulatory stage was created experimentally in 26-day-old immature ovaries by stimulating 48 h earlier with hCG, the intense staining of the granulosa cells surrounding the oocytes from untreated ovaries was lost in the cumulus cells of such hCG-treated animals. This temporal pattern of MIS staining and the prior demonstration that MIS could inhibit in vitro meiosis of oocytes from untreated immature rats suggest that this regressor, well characterized in the fetal testis, might function in the ovary as a regulator of oocyte maturation and follicular development during the adult reproductive cycle.
Animals↗
A case of normotensive primary aldosteronism with hypopituitarism, epilepsy, and medullary sponge kidney.
A 55-year-old man with normotensive primary aldosteronism, hypopituitarism, epilepsy, and medullary sponge kidney is reported. Seventeen years before admission, he had been noted to have hypokalemia associated with high potassium clearance, suppressed plasma renin activity, metabolic alkalosis, and normal blood pressure as well as low urinary excretion of 17-hydroxycorticosteroids. He kept normotensive in spite of hyperaldosteronism until nine months after the initiation of replacement therapy with glucocorticoid and thyroxine for hypopituitarism, when he became hypertensive. Hypopituitarism seemed to play a role in keeping a normal blood pressure despite long-standing hyperaldosteronism.
Adrenal Glands↗
[Prediction of coronary artery lesions by two-dimensional echocardiography at rest and during exercise: in patients with left anterior descending artery lesion].
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Adult↗
[Mass screening of cardiovascular disorders by two-dimensional echocardiography].
We used two-dimensional echocardiography (2-D echo) for the mass screening of 2,673 subjects for cardiovascular disorders (1,032 men, 1,641 women, aged 23-95 years with a mean age of 59), who lived in 12 rural areas in Japan. In 1,665 of the 2,673 subjects (62.3%), cardiac abnormalities were recognized. Three major abnormalities included sclerotic aortic (33.0%) and mitral valves (21.8%), and left ventricular (LV) hypertrophy (15.9%). Apparent pericardial effusion (54 cases), mitral valve prolapse (44 cases), and dilated cardiomyopathy (4 cases) were incidentally found in this study. Prevalence of the abnormalities insidiously increased with age (below 49 years: 39%, and above 80 years: 97%), and this was apparently higher in men than in women. The abnormal findings which were significantly higher in men were the sclerotic aortic valves, LV hypertrophy and dysfunction, the prevalence of which was particularly high in ages 40-79, but it became nearly equal beyond 80 years of age. These results may indicate a sexual difference in the influence of age on the cardiovascular system. It was concluded that 2-D echo is helpful for primary screening and prevention of cardiovascular disorders.
Adult↗
[Usefulness of subcutaneously implanted reservoir for postoperative therapy in hepatocellular carcinoma and liver metastases of colorectal carcinoma].
Hepatectomy has been a treatment of choice for hepatocellular carcinoma and metastatic liver carcinoma. Recurrence in residual liver after hepatectomy is clinically a serious problem. Since 1987, postoperative hepatic arterial infusion chemotherapy using subcutaneously implanted reservoir has been undertaken to improve the prognosis after hepatectomy in hepatocellular carcinoma and liver metastasis of colorectal carcinoma. The indications for reservoir implantation were determined for high-risk cases in hepatocellular carcinoma and all cases in liver metastasis. The tip of a catheter was placed at the root of the common hepatic artery via gastroduodenal artery. Lipiodol-ADM was injected for hepatocellular carcinoma every 2 months and MMC-5-FU was injected for liver metastasis of colorectal carcinoma every one or two weeks. Complications of this procedure in every 2 cases of reservoir infection proved to be catheter obstruction and hepatic artery obstruction. In the process of this treatment, we observed 3 recurrences in residual liver of hepatocellular carcinoma and one case of peritoneal dissemination and 3 recurrences in residual liver of liver metastasis of colorectal carcinoma. All are still alive.
Antineoplastic Combined Chemotherapy Protocols↗
[Angiomyolipoma of the kidney; report of two cases with a low fat component].
We report two cases of unilateral renal angiomyolipoma. In both cases, our preoperative diagnosis was renal cell carcinoma because no low density area compatible with a fatty tissue was noted in the tumors. Histological examination revealed both tumors to be angiomyolipoma mainly composed of myomatous cells and immature fat cells.
Adult↗
[Ultrasonography of the adrenal glands].
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Adrenal Gland Diseases↗
[A case of early stage double carcinomas arising in the duodenum and stomach].
The first Japanese case of early stage double carcinomas arising in the duodenum and the stomach is reported. The patient, a 69-year-old man, visited our hospital chiefly complaining of an epigastric pain. X-ray and endoscopic examinations of the upper gastrointestinal tract revealed a slightly depressed lesion at the antrum of the stomach and a pedunculated polyp at the 2nd portion of the duodenum. A pancreatoduodenectomy combined with a subtotal gastrectomy was performed and reconstruction was accomplished by the Billroth 1 procedure. A pathologic study of the removed specimens revealed two foci of carcinoma limited to the mucosal layer of the stomach and the duodenum and lymph nodes without metastasis. The postoperative course of the patient was uneventful.
Adenocarcinoma↗
Comparison of arachidonic acid metabolism between myofibroblasts and fibroblasts isolated from rat palatal mucoperiosteum.
Myofibroblasts were cultured successfully from experimental wound tissue in rat palatal mucoperiosteum. Arachidonic acid metabolizing activity in cultured myofibroblasts was compared with that in fibroblasts cultured from normal mucoperiosteum. Prostaglandins biosynthesized from [14C]arachidonic acid in cell-free homogenates of both myofibroblasts and fibroblasts were prostaglandins D2, E2 and F2 alpha, and the activity producing each prostaglandin was not significantly different between the myofibroblasts and the fibroblasts, whereas smooth muscle cells, which are histologically similar to myofibroblasts, produced mainly 6-ketoprostaglandin F1 alpha, and relatively small amounts of prostaglandin E2. The release of arachidonic acid from cells prelabeled with [14C]arachidonic acid was compared among three types of cell. The calcium ionophore A23187 strongly enhanced arachidonic acid release in all three cell types. Bradykinin, 5-hydroxytryptamine and prostaglandin F2 alpha affected the stimulation of arachidonic acid release in the fibroblasts but were less or not effective in the myofibroblasts and smooth muscle cells. In addition, prostaglandin E2 biosynthesized in response to several stimuli was measured by radioimmunoassay. The content of prostaglandin E2 correlated closely with arachidonic acid release. In this study, we showed homogeneity between the myofibroblasts and fibroblasts in prostaglandin synthesizing activity and similarity in response to various stimuli between the myofibroblasts and smooth muscle cells, from the standpoint of arachidonic acid metabolism.
Animals↗
Mechanism of pancreatic hypersecretion in dogs with obstructive jaundice.
Pancreatic exocrine function in experimental obstructive jaundice was examined using dogs. Outputs of pancreatic juice, bicarbonate and amylase were greater in dogs with obstructive jaundice than in control dogs. To further examine the hypersecretory mechanism in obstructive jaundice, we examined pancreatic exocrine secretion stimulated by secretin and pancreozymin in both the isolated perfused pancreas and pancreatic dispersed cell culture. The perfused pancreas stimulated with secretin and pancreozymin in dogs with obstructive jaundice showed higher secretion of volume, bicarbonate and amylase than in control dogs. Dispersed pancreatic cells of jaundiced dogs stimulated by secretin and pancreozymin released more bicarbonate and amylase into the media than dispersed cells of control dogs. These data suggest pancreatic hypersecretion in obstructive jaundice is not due to excessive serum levels of secretin and pancreozymin or impaired metabolism of these hormones.
Amylases↗