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Biomedical subjects

T Oku

Publications and source records attributed to T Oku.

At least 109 records · Page 6Linked to original sources
PubMed1991

[Utility and limitation of sequential saphenous vein graft for complete revascularization in coronary artery surgery].

Multiple bypass grafting in complete myocardial revascularization requires frequently the use of sequential saphenous vein grafts as well as arterial grafts. To expect the favorable good clinical results of revascularization, therefore, refined surgical technique for saphenous vein grafting and proper selection of suitable coronary arteries for bypass are important. Between January 1989 and April 1990, 91 patients underwent CABG utilizing internal thoracic arteries (ITA) in 79% and SVG in 99% of the patients with an average of 3.3 anastomoses per patients. Postoperative angiography was performed 4 or 8 weeks after surgery. Early patency rates were 92% (204/221) in overall anastomotic sites, 96% (52/54) in ITA and 91% (152/167) in SVG respectively. There was no difference in patency rates between individual (90%) and sequential (92%) grafts. In sequential grafting, however, patency rate of side-to-side anastomosis was higher than that of end-to-side anastomosis. Patency rates of the grafts were also evaluated in terms of the sizes of coronary arteries and intraoperative graft flows. These studies lead to the following conclusions: In individual grafting, the acceptable patency rate can be expected when the graft flow exceeds 30 ml/min even if the internal diameter of coronary artery is less than 1.5 mm. In sequential grafting, on the other hand, a diameter more than 1.5 mm is desirable for the coronary artery at the site of end-to-side anastomosis.

Adult↗
PubMed1991

[Clinical study of eel calcitonin for relief of pain from metastatic bone lesions].

Thirty patients with bone metastasis were treated with eel calcitonin (CT) to relieve severe pain from metastatic bone lesions. Patients were two males and twenty-eight females with a mean age of 52.8. CT was administered intramuscularly in twenty-seven patients and intravenously in three. CT was effective on 55.6% of patients to reduce severe bone pain but did not decrease the amount of analgesics in most patients. Serum Ca and P were not changed markedly. As side-effects, two patients complained of nausea and vomiting after administration of CT but they weren't severe. These results indicate that CT is quite useful drug for relief of severe bone pain from metastatic lesions in patients with breast or digestive tract carcinomas.

Adult↗
PubMed1990

Right ventricular myocardial infarction and late cardiac tamponade due to right coronary artery aneurysm--a case report.

Coronary artery aneurysm is a relatively rare disease, which may cause angina, myocardial infarction, or sudden unexpected death due to thrombosis, embolization or rupture. This report describes a case of a 46 year old male who suffered an inferior myocardial infarction with right ventricular involvement, third degree atrioventricular block, cardiogenic shock and late cardiac tamponade, all caused by a right coronary artery aneurysm. He was successfully treated with emergency coronary artery bypass grafting. A review of the literature is also given to emphasize the importance of prompt recognition and correct management of the coronary artery aneurysm.

Cardiac Tamponade↗
PubMed1990

Simultaneous coronary and abdominal aortic surgery--a report of two cases.

Myocardial infarction is a major cause of operative mortality following abdominal aortic surgery. For this reason, routine coronary angiography and, if indicated, coronary revascularization prior to aneurysm repair is recommended. Nevertheless, some controversy still exists concerning the risks of aneurysm rupture and myocardial ischemic events when repair or coronary surgery is staged. This report describes two successful cases of simultaneous surgery for an expanding aneurysm and severe coronary artery disease, emphasizing the usefulness of gastroepiploic artery grafting in such cases.

Aged↗
PubMed1990

Comparison of prostacyclin production of human gastroepiploic artery and saphenous vein.

The prostacyclin production of the gastroepiploic artery (GEA) and saphenous vein (SV) were studied in 5 patients undergoing coronary artery revascularization. The GEA produced 90.0 +/- 11.9, 132.4 +/- 13.7, and 191.1 +/- 21.8 pg/mg tissue (mean +/- standard error of the mean) of 6-keto-prostaglandin F1 alpha (prostacyclin metabolite) after 2.5, 5.0, and 10.0 minutes, respectively, of incubation in Krebs-Henseleit buffer at 37 degrees C. The SV produced 39.8 +/- 7.0, 66.7 +/- 9.1, and 123.6 +/- 15.1 pg/mg tissue of 6-keto prostaglandin F1 alpha after 2.5, 5.0, and 10.0 minutes, respectively, of incubation. The GEA produced significantly more 6-keto-prostaglandin F1 alpha than SV at all three sampling times up to ten minutes of incubation (p less than 0.01). Prostacyclin is a potent vasodilator and an inhibitor of platelet aggregation. Prostacyclin production by the internal mammary artery was reported to be much higher than that of SV, and the patency rate of internal mammary artery grafts is reported to be better than that of SV grafts in coronary artery revascularization. Therefore, our results suggest that the patency rate of GEA grafts may be better than that of SV grafts in coronary artery revascularization. The GEA is a promising and excellent graft from the biochemical point of view.

6-Ketoprostaglandin F1 alpha↗
PubMed1990

Free arterial graft as internal mammary artery-Y complex.

Because of excellent surgical results obtained with in situ internal mammary artery grafts, recent efforts have been made to extend the use of arterial conduits. In this study 2 cases of coronary revascularization using free internal mammary artery and gastroepiploic artery grafts as an internal mammary artery-Y complex are described. We believe that complete revascularization with only arterial conduit can be achieved more widely by using this technique.

Aged↗
PubMed1990

Pharmacological response of internal mammary artery and gastroepiploic artery.

Pharmacological response of coronary artery bypass conduit is of great importance. This study was designed to clarify the contractile properties of internal mammary artery and gastroepiploic artery obtained from coronary revascularization. The response to ergonovine, serotonin, and phenylephrine was examined by isometric contraction recording apparatus. The concentration-response relation of both internal mammary artery and gastroepiploic artery to ergonovine, serotonin, and phenylephrine showed similar sigmoid curves. There were no significant differences in developed tension between internal mammary artery and gastroepiploic artery at any concentration for any agent. There were no significant differences in the 50% effective dose value for any agent between internal mammary artery and gastroepiploic artery. Internal mammary artery and gastroepiploic artery are reported to be similar in terms of size, flow capacity, and freedom from atherosclerosis. This study shows their equivalence from a pharmacological viewpoint.

Arteries↗
PubMed1990

Easy dissection of hard and thickened pericardium on constrictive pericarditis.

The keys to successful pericardiectomy for constrictive pericarditis are early operation and as complete a pericardiectomy as possible. With the high-speed burr it is easy and safe to dissect the calcified pericardium and define the epicardium even in a small operative field such as the inferior or posterior portion of the heart. This method has the important ability to perform very complete pericardiectomy.

Adult↗
PubMed1990

A peculiar form of epidermotropism in cutaneous metastatic carcinoma.

A 71-year-old man developed metastatic cutaneous nodules of colon carcinoma on the scalp and chest wall. Histopathological findings revealed aggressive invasion of the tumor cells into the overlying epidermis (epidermotropic carcinoma); they occasionally adhered to the epidermal cells. These morphological features have not been described in cutaneous metastases from internal carcinomas.

Adenocarcinoma↗
PubMed1990

Vascular stenting in normal and atherosclerotic rabbits. Studies of the intravascular endoprosthesis of titanium-nickel-alloy.

Percutaneous transluminal balloon angioplasty would be more effective if the rate of recurrent stenosis were reduced. To evaluate the prevention of restenosis after percutaneous transluminal angioplasty, intravascular endoprosthetic stents of titanium-nickel-alloy were implanted transluminally in seven normal and 21 atherosclerotic rabbits. In normal rabbits, a 3.5-mm diameter stent was implanted in the aorta and a 2.5-mm diameter stent in the right iliac artery, which were followed with serial angiograms from 6 weeks (n = 7) to 8 months (n = 4). There was a mean stenosis of 13.1% in the 2.5-mm and 13.6% in the 3.5-mm stent. There was no significant narrowing compared with the adjacent control segments of artery; histopathology showed a thin, fibrous neointima with smooth muscle cells. Each atherosclerotic rabbit was balloon dilated at two separate stenotic sites; each site was 2.0 cm in length. The aortic site (with 28.8 +/- 13.8% mean stenosis [+/- SD]) was dilated with a 3.5-mm balloon, and the iliac site (with 36.5 +/- 14.2% stenosis) was dilated with a 2.5-mm balloon. In each site, an intravascular stent of corresponding diameter and 7-mm length was implanted in one half of the dilated segment, assigned randomly, and the other half served as the angioplasty control. Angiographically observed restenosis rates and the corresponding histopathology were similar in the atherosclerotic segments that had angioplasty alone versus the atherosclerotic segments that had angioplasty plus stenting. The mean neointimal thickness in the aortas and iliac arteries, respectively, measured 247 +/- 181 microns (+/- SD) and 218 +/- 77 microns after 6 weeks (n = 8) versus 321 +/- 168 and 308 +/- 189 microns after 20 weeks (n = 5, p = NS). At 20 weeks follow-up, there was 29.1 +/- 29.8% (median, 16.4%) stenosis in the aortic stent versus 38.9 +/- 24.1% (median, 34.0%) stenosis in the percutaneous transluminal angioplasty control segment of aorta (n = 5, p = NS) and 81.4 +/- 25.5% stenosis in the iliac artery stent versus 89.3 +/- 15.3% stenosis in the PTA control segment of the right iliac artery (n = 5, p = NS). Comparing stenotic arterial segments treated with angioplasty alone with angioplasty plus intravascular stenting in the atherosclerotic rabbits showed that there was no significant difference in either the histopathologic changes or the restenosis rates.

Alloys↗
PubMed1990

Growth kinetics of fibroblasts from a patient with Ehlers-Danlos syndrome.

A 6-year-old girl with Ehlers-Danlos syndrome (type I) who shows hyperelastic skin, hypermobile joints and delayed wound healing is reported. The growth kinetics of fibroblasts derived from her skin was examined using 3H-thymidine autoradiography. Our study showed that these fibroblasts had poor proliferative activity, compared with normal age-matched fibroblasts. Thus, we could suggest that the pathogenesis of Ehlers-Danlos syndrome was partially attributed to the lack of proliferative activity of the fibroblasts.

Autoradiography↗
PubMed1990

[The trends of the TMJ patients on dental clinic of pediatric dentistry. Comparison finished patients with discontinued patients by questionnaire].

We made a follow-up survey on the TMJ dysfunction syndrome patients who visited our clinic, using questionnaires for the purpose of raising the dental management of TMJ dysfunction syndrome patients and obtained as following results. 1. The percentage of questionnaires which were sent back was 61.5% with the finished group, and was 38.9% with the discontinued group. The average percentage for all subjects was 50.7%. 2. From the results from all subjects who answered the questionnaire and sent them back, it was found that the ratio of the patients who had understanding of the explanation before the treatment of the TMJ dysfunction syndrome was 60.5%. The ratio of the patients who answered "I could not use the splint completely" was 2.6%, and the ratio of the patients who answered "I used the splint completely in spite of malaise when using it" was 84.2%. The ratio of the patients who answered "I felt that treat time was long" was 57.9%. The ratio of the patients who had a relapse of the symptom after treatment was 33.3%, but 22.2% of their symptoms were temporary and soon disappeared. 3. There were 4 questions which showed statistical significant differences between the finished group and the discontinued group. They were the attitude to the treatment after examination at first visit, period of time the splint was used, complaint of discomfort while using the splint, concerned mind of visiting interval. 4. The rate of the patients who complained of the limitation of jaw at the first time was higher with the finished group than with the discontinued group.

Child↗
PubMed1990

[A study of active induction of orthodontic therapy in TMJ dysfunction syndrome--from the data of patients with TMJ dysfunction in adolescents].

It seems that active orthodontic therapy using multi-bracket appliances presents effective assurance of a physiological stable occlusion for TMJ dysfunction syndrome in adolescents. The efficiency and problems concerning the progress of active orthodontic therapy after splint therapy were examined from the data of the change of occlusal conditions, and the function of masticatory muscles before and after therapy for TMJ dysfunction from four cases for which we performed orthodontic therapy activity. 1. All of the occurring symptoms of the TMJ dysfunction syndrome (limitation, pain, sound) in the progress of orthodontic therapy were concerned with using intermaxillary elastic. The symptom which occurred in process of using only intra-maxillary elastic was just a malaise of the TMJ. Also the sound of the TMJ relapsed in the process of using class III intermaxillary elastic and recurred after the multi-bracket appliance was removed. In this case, the condylar vertical position after orthodontic therapy changed from the lower position to the center position compared with the first visit. 2. Malocclusion was improved with orthodontic therapy in all four patients. 3. The function of the masticatory muscles after orthodontic therapy was improved in comparison with the first visit by evaluation of the masticatory muscles activity and the state of silent period.

Adolescent↗
PubMed1990

[Flow cytometric cell cycle analysis of lymphocytes in patients with drug eruption].

DNA synthesis of lymphocytes was analyzed by flow cytometry in patients with drug eruption, eczema, viral eruption, and normal individuals. Lymphocytes were taken from the patients having fresh skin rash. In the patients with drug eruption, the percentages of lymphocytes in the G0G1 phase were lower and those in S + G2M phase were higher than the values in other groups, indicating the occurrence of blastogenic reaction. We considered that this method was helpful for diagnosis of drug eruption.

Adult↗
PubMed1990

[Contractile properties of coronary artery bypass conduit--comparison between saphenous vein and internal mammary artery].

This study was designed to examine the response of coronary artery bypass conduit to serotonin, phenylephrine, and ergonovine as provocation agents of vasoconstriction. Saphenous veins (SV) and internal mammary arteries (IMA) were obtained during coronary artery bypass grafting (CABG), and their contractile properties were measured using isometric contraction recording apparatus. Both SV and IMA showed sigmoid contraction curves indicating dose dependence to ergonovine, serotonin, and phenylephrine. The concentration-response relations for phenylephrine showed a similar curve in both SV and IMA, however, those for ergonovine and serotonin showed a leftward shift in SV compared with IMA. Half maximum effective dose for ergonovine and serotonin were less in SV than IMA. From these results, it was suggested that "perioperative spasm" during CABG might occur not only in coronary arteries but also in the graft conduit itself. Graft spasm might be a possible mechanism for occlusion of the bypass graft. In conclusion, greater hyperreactivity of SV compared with IMA in response to ergonovine and serotonin was suggested, so it is concluded that, from this point of view, IMA is more suitable for use in CABG.

Coronary Artery Bypass↗
PubMed1990

The familial occurrence of bullous mastocytosis (diffuse cutaneous mastocytosis).

We studied four patients (a mother, her two daughters, and her son) with bullous mastocytosis, or diffuse cutaneous mastocytosis, whose genetic inheritance suggested an autosomal dominant pattern. The clinical characteristics included extensive bullae, numerous urticaria, pruritus, flushing, and pseudolichenified skin over all body surfaces without systemic organ involvement. The histopathologic findings disclosed a pronounced accumulation of mast cells in the dermis. Electron microscopic studies of lesional skin obtained in infancy showed round or spindle-shaped mast cells with numerous fingerlike villous protrusions. The cytoplasmic granules varied in size and shape, and the appearance of degranulation was markedly noted. In the adult, most mast cells had markedly decreased numbers of granules and cytoplasmic villi. Some cells displayed degenerative or necrotic appearances. These findings correlated well with the clinical course of these cases, which improved spontaneously over time.

Adult↗
PubMed1990

[Coronary revascularization for patients requiring steroids. A report of three cases].

Three patients with systemic disease requiring steroids, in whom coronary artery bypass grafting (CABG) was performed, are reported in this paper, Anesthetic problems and operative managements for such patients are also discussed. Patient 1, 57-year-old male with thrombocytosis underwent emergency double CABG using saphenous vein and the Bioflow graft. He discharged with freedom from angina. Patient 2, 59-year-old male with polymyositis who had been receiving steroid for 10 years underwent quadruple CABG using bilateral internal thoracic arteries with sequential technique and the Bioflow graft, but he died of multiple organ failure on 16 days after operation. Postmortem examination revealed that coronary artery sclerosis progressed more severely than we had expected from angiography. All the graft anastomosed were completely patent. Histological examination showed that the saphenous vein was fragile. The pathological changes might be due to steroid administration. On the other hand, arterial grafts were completely normal. Patient 3, 37-year-old male with idiopathic thrombocytopenic purpura who had been on steroids underwent combined triple CABG using internal thoracic artery, gastroepiploic artery and the Bioflow graft and splenectomy. He discharged with freedom from angina and tendency to bleed. Postoperative angiography showed both arterial grafts were well patent and left ventricular wall motion vastly improved. From our experience, a careful consideration of the bypass conduit is a major problem in such patients requiring steroids.

Adult↗