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T Ueda

Publications and source records attributed to T Ueda.

At least 793 records · Page 44Linked to original sources
PubMed1994

[A case of Rubinstein-Taybi syndrome with bilateral vesicoureteral reflux].

The case was in a 7-month-old boy. Rubinstein-Taybi syndrome was diagnosed from the broad halluces and the characteristic physiognomy noticed since birth. He was brought to us at 7 months of age with fever as the chief complaint. Voiding cystourethrogram showed bilateral vesicoureteral reflux. The testis was palpable in the inguinal canal on either side, but could not be brought to the scrotum. No abnormalities were detected in the penis. From the above findings, he was diagnosed to have bilateral 4th degree vesicoureteral reflux and undescended testes as complicating Rubinstein-Taybi syndrome. The condition was treated by bilateral anti-reflux repair and bilateral orchidopexy at 8 months of age. There has been no recurrence of vesicoureteral reflux for 3 years. A brief discussion was made about the urological complications of Rubinstein-Taybi syndrome.

Cryptorchidism↗
PubMed1994

[A case of thoracoscopic pulmonary lobectomy for lung cancer].

A case of thoracoscopic right lower pulmonary lobectomy is reported. A 79-year-old man was admitted to our hospital after the accidental finding of a right pulmonary growth. A computed tomography (CT) scan of the thorax confirmed the presence of a neoplasm, 2.5 cm in diameter, at the posterior-basal segment of the right lower lobe. Considering the general condition of the patient and the characteristics of the lesion, we decided to perform a assess the possibility of a thoracoscopic lobectomy instead of the traditional posterolateral approach. The pulmonary artery was dissected with the new endoscopic cherry dissector, and ligated with the polyester suture material and Endo Clip then dived with Endo scissors. The lower pulmonary vein was dissected with this endoscopic cherry dissector and divided with Endo GIA 30 clamping the new thoracoscopic De Bakey type vascular clamp. The specimen was extracted through the minimal thoracotomy (15 cm). The postoperative course was uneventful with minimal postoperative pain, and the patient was discharged after complete surgical recovery with excellent functional and cosmetic results.

Aged↗
PubMed1994

[Clinical evaluation of sulbactam/cefoperazone for infections during the chemotherapy of hematologic malignancy].

In 28 patients with hematologic malignancy, the clinical effect and the safety of sulbactam/cefoperazone (SBT/CPZ) were studied on 45 episodes during granulocytopenic stage after antineoplastic chemotherapy. The overall efficacy rate obtained with SBT/CPZ in combination with other drugs was 62%. The rates for sepsis, suspected sepsis and pneumonia were 67%, 94% and 38%, respectively. The efficacy in those cases that showed granulocyte count less than 300/microliters during the course of administration of SBT/CPZ was 53%, and in those cases that showed granulocyte counts recovery to more than 300/microliters was 73%. Prior antimicrobiological treatments had no influence on the efficacy of SBT/CPZ. SBT/CPZ showed an activity spectrum covering frequently isolated microorganism including Acinetobacter calcoaceticus, Pseudomonas aeruginosa, Enterobacter cloacae and Staphylococcus aureus. Mild adverse effect were observed in 4 episodes (8.8%). These result suggested that SBT/CPZ was thought to be a useful drug for empirical therapy in granulocytopenic patients with hematologic malignancies.

Adolescent↗
PubMed1994

[Surgical treatment of descending thoracic aortic aneurysm with simple aortic cross-clamping versus left heart bypass using centrifugal pump].

Surgical treatment has been employed in 52 patients (pts) with descending thoracic aortic aneurysm (DS-TAA). Based on the adjuncts during aneurysmal repair, the series is divided into 2 groups; simple aortic cross-clamping was utilized to manage the lesion in group SC (n = 42), while left heart bypass using a centrifugal pump was employed during the period of aortic occlusion in LHB group (n = 10). Of these 52 pts, 4 died in hospital (group SC:2, group LHB:2). The most common complication was the respiratory failure following the renal failure. No paraplegia occurred in both groups. Biochemistric measurements of alanine aminotransferase, creatinine (CRN) and amylase (AMY) showed no difference between group SC and group LHB. In pts of SC group with normal renal function, post-operative maximum (post Max) CRN during the first month had a logarithmic correlation with total aortic cross-clamp time (TAXT). The post Max CRN of LHB group with normal renal function remained less than 3.0 mg/dl even in the case with TAXT over 60 minutes. There is also a linear correlation of post Max AMY in pts of SC group. Late survival at 4 years, including hospital death, were 83% in SC group and 63% in LHB group. We conclude that DS-TAA cases with TAXT of less than 30 min with good distal organ function can be managed with simple aortic cross-clamping; otherwise usage of LHB was recommended to support distal circulation.

Adult↗
PubMed1994

Influence of psychological stress on suckling-induced pulsatile oxytocin release.

OBJECTIVE: To investigate the influence of psychological stress on suckling-induced oxytocin release. METHODS: The pulsatile release of suckling-induced oxytocin was measured in 22 puerperal women. The blood samples for oxytocin assay were collected at 2-minute intervals in a manner that minimized degradation by plasma oxytocinase, and were used for radioimmunoassay after extraction. RESULTS: The release of suckling-induced oxytocin during nursing is pulsatile, with discrete, short pulses. The frequency of pulsatile release of oxytocin was significantly lower in the two groups in which stress was imposed by mental calculation or noise than in the control group without stress (mental calculation group, 1.28 +/- 0.76 pulses/20-minute suckling period; noise group, 1.14 +/- 0.38; control group, 2.25 +/- 0.71). However, there were no differences among the three groups in the increase of prolactin during nursing or in the milk yield. CONCLUSIONS: The release of suckling-induced oxytocin is pulsatile, and psychological stress reduces the pulsatile oxytocin release. Our data suggest that suckling-induced oxytocin release may be modulated by the central nervous system and that psychological relaxation is necessary for an adequate let-down response.

Adult↗
PubMed1994

[Caregiving burden of elderly caregivers who provide at home care for infirm elderly].

In order to elucidate the degree of feeling burdened and factors affecting caregiving burden of elderly caregivers, a questionnaire survey was performed on 241 female caregivers of infirm elderly. The surveyed group consisted of 138 caregivers under 60 years of age (young group) and 103 aged 60 and over (old group). The major results of this survey were as follows, 1) Conditions perceived as unfavorable in the old group were related to caregiving assistants, number of the family members and health condition of the caregiver. 2) Greater number of infirm elderly with serious ADL problems and higher average body weight of the elderly cared for were seen for the old group than the young group. 3) The old group had a larger number of problem incidents and expressed more eager desire for transfer of elderly to institutional care than providing the young group. 4) A feeling of burden in daily care appeared larger for night care, body discharge disposal and bathing care of the elderly and was more frequent in those above 70 than under 70 years of age. 5) Hours in bed were longer and range of movement by wheel chair was more limited for infirm elderly as the caregiver's age increased. These results suggest that the above-mentioned unfavorable conditions in elderly caregivers promote a state of becoming bedridden and a lowering of ADL ability of infirm elderly.

Activities of Daily Living↗
PubMed1994

[Treatment with arbekacin of surgical infections by resistant strains of Staphylococcus aureus. Arbekacin Study Group].

The frequency of infection by methicillin-resistant Staphylococcus aureus (MRSA) is high in Japan and control of such strains is urgently needed. Arbekacin (ABK), a semisynthetic aminoglycoside, has potent activity against S. aureus, including resistant strains, and against Gram-negative bacteria as well. For this reason, in surgical infections (which are often caused by more than one bacterium), this drug might be particularly effective. We calculated the MIC and the decrease in the MIC when cultures of 59 resistant strains of S. aureus isolated in our wards at Osaka City University Hospital, contained arbekacin in the medium. We also used the drug to treat 12 infections caused by resistant strains of S. aureus. The MICs of vancomycin had a single peak at 0.5 microgram/ml, and those for ABK had double peaks at 0.5 and 4.0 micrograms/ml. The effect of arbekacin in lowering the MIC of minocycline (MINO) was slight because of the low MIC of MINO. Effects on fosfomycin (FOM), ampicillin, clavulanic acid/ticarcillin, cefotiam, cefuzonam, flomoxef, and imipenem/cilastatin were strong; the peaks were lowered by 1/2(7)-1/2(11). When 1.0 micrograms/ml ABK was present in the medium, the efficacy of FOM was increased enough that, by prediction from the pharmacokinetics of FOM (blood level when given at the usual dose), all but one (2%) of the 47 resistant strains would be eradicated clinically. If 2.0 micrograms/ml ABK were in the medium, all strain would be eradicated, by our calculations. We treated 11 infections and one colonization by resistant strains of S. aureus with ABK and evaluated the response in these cases of infection. Four infections were treated with FOM as well. The clinical efficacy was good in four infections (three patients), fair in four, and poor in three, for an efficacy rate of 36%. All presumed causative bacteria were eradicated in two (18%) of the 11 infections and S. aureus strains were eradicated in three (27%) of the 11 infections. No symptoms of side effects were reported, but blood urea nitrogen and creatinine rose in a 72-year-old woman with duodenal perforation and peritonitis. The MIC levels of ABK were satisfactory, but clinical efficacy for staphylococcal infections caused by resistant strains was unsatisfactory.

Adult↗
PubMed1994

[A case of subacute stroke with high uptake of 99mTc-HMPAO in the reperfused infarct corresponding to low perfusion area].

We reported a case of subacute stroke which showed high uptake of 99mTc-d,l-hexamethylpropyleneamine oxime (HMPAO) in the reperfused infarct corresponding to slightly decreased perfusion by 133Xe inhalation CBF measurement. In the chronic stage, both SPECT images of 99mTc-HMPAO and 133Xe showed low perfusion in the affected lesion. It was, therefore, considered that the high uptake of 99mTc-HMPAO had represented luxury perfusion. In the subacute stage of stroke, high uptake of 99mTc-HMPAO may imply luxury perfusion but not always hyperperfusion. It is suggested that the fractional fixation of 99mTc-HMPAO temporarily change in the affected lesion and it is essential to take into consideration the clinical stage for the interpretation of SPECT images.

Acute Disease↗
PubMed1994

Cerebral blood flow study in patients with moyamoya disease evaluated by IMP SPECT.

UNLABELLED: We studied the usefulness of IMP SPECT with acetazolamide in 16 patients with moyamoya disease. Cerebral angiography was performed for all patients who were classified in three grades according to their angiographic stages. METHODS: Techniques used included ring-type emission computed tomography with a minicomputer system. Patients received 111 MBq of 123I-IMP and SPECT images were obtained 20 min postinjection. Nine patients were studied using iodoamphetamine (IMP) SPECT with and without acetazolamide. IMP SPECT with acetazolamide was performed 20 min after each injection of 1 g of acetazolamide. RESULTS: Low perfusion areas in the upper and lower frontal, parietal and temporal regions in grades 2 and 3 using IMP SPECT were observed. The mean cerebral-to-cerebellar activity ratios (C/C ratio) of six regions (upper and lower frontal, temporal, parietal occipital and basal ganglia) in grades 1, 2 and 3 were 0.96 to 1.06, 0.91 to 0.96 and 0.76 to 0.88, respectively. CONCLUSION: Our results indicate that measurement of regional cerebral blood flow (rCBF) elucidates cerebral hemodynamic factors, including the reactivity of cerebral vessels which cannot be detected angiographically in patients with moyamoya disease, and that the acetazolamide test is useful for detecting cerebral blood flow reserve. The test can be used to detect disease progress prospectively.

Acetazolamide↗
PubMed1994

Measurement of portal systemic shunting by oral and per-rectal administration of [123I]iodoamphetamine, and clinical use of the results.

UNLABELLED: OBJECTIVE. We used a method by which the portal shunt index via the superior mesenteric vein (SI-S) and that via the inferior mesenteric vein (SI-I) could be evaluated simultaneously. The clinical usefulness of the method was studied. METHODS: Scintigraphy was done 3 h after subjects took an enteric-coated capsule containing [123I]iodoamphetamine. At that time, the radionuclide was injected into the rectum. Counts for the lungs and the liver were used to calculate the two shunt indices. RESULTS: The mean SI-S and SI-I tended to be higher for disorders that were more severe, increasing in the order of chronic persistent hepatitis, chronic aggressive hepatitis, and cirrhosis. In cirrhotic patients, the SI-I was higher than the SI-S (p < 0.001). The SI-S and SI-I were both higher in cirrhotic patients with esophageal varices than in such patients without varices (p < 0.05 and < 0.001). The SI-S and SI-I were higher in cirrhotic patients with ascites than in such patients without ascites (p < 0.001 and < 0.01). Correlation between either of these indices and classical indicators of functional reserve was high. The correlation of SI-S with the Child-Turcotte classification and total bilirubin level was higher than the correlation of the SI-I and these indicators of functional reserve. CONCLUSIONS: This method permits assessment of the portal hemodynamics in a relatively noninvasive way, and is clinically meaningful.

Administration, Oral↗
PubMed1994

[Removal of infected total pacemaker system under extracorporeal circulation--a case report and review of the Japanese literature].

A 35-year-old male with sick sinus syndrome was complicated with recurrent local infection at the site of the generator pocket associate with a retained pacemaker lead, followed by septicemia presenting with Staphylococcus aureus. Several attempts to remove the lead via the implantation vein by direct traction were performed unsuccessfully because the leads were strongly adhered to the trabecula of the right ventricle. Repeated debridement employing antibiotic therapy was ineffective. As a last resort, we finally operated under extracorporeal circulation (ECC) 24 months after the first implantation and 22 months after initiation of the local infectious episode. As we found it difficult to remove the leads by traction even under direct vision, we used the vinyl chloride tube, which is a part of the ECC circuit, as a sheath for applying countertraction around the lead tip to prevent the myocardial wall from being torn and extracted together with the lead tip. The lead was removed successfully and a new epicardial lead was implanted. The postoperative course uneventful and no recurrence has occurred after 1 year. In reviewing the Japanese literature, 10 case, operated on under ECC to remove the infected retained leads, were described in detail. Among them, eight cases had undergone previous debridement including removal of the generator and the subcutaneous portion of the lead. It is clear that removal of all of the pacemaker system is necessary for eradication of infection. Adhesion of the lead to the wall is firm. Only one case besides ours succeeded in having its lead removed without requiring incision of the tissue around the lead tip.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

[Redo operations for dissecting aortic aneurysm].

We reoperated twenty-four times upon twenty cases of dissecting aortic aneurysm since 1983. Nine of them (45%) were Marfan patients. Reoperations on the same part of the aorta as the prior procedure was done 15 times upon 13 cases with six hospital deaths (40%). Reoperations on the different part of the aorta from the prior operation was done 9 times on 9 cases with one hospital death (11%). Over all hospital mortality rate was 29%. The hospital mortality rate for Marfan patients (8%) was significantly better than that for non-Marfan patients (50%).

Adult↗
PubMed1993

Role of calcium ion in induction of apoptosis by etoposide in human leukemia HL-60 cells.

The epipodophyllotoxin derivative etoposide, an inhibitor of DNA topoisomerase II, has been found to induce internucleosomal DNA fragmentation, characteristic of apoptosis. In the present study, we examined the effect of Ca2+ depletion on VP-16-induced endonucleolytic DNA cleavage in HL-60 cells. VP-16-induced internucleosomal DNA fragmentation could not be blocked by the extracellular Ca2+ chelator EGTA. However, an intracellular Ca2+ chelator BAPTA-AM, which was added after treatment with VP-16, abolished both internucleosomal DNA fragmentation and the morphologic features of apoptosis. No significant increase of intracellular Ca2+ was found after VP-16 treatment. We demonstrate for the first time that preexisting intracellular Ca2+ plays an essential role in induction of apoptosis by VP-16 in HL-60 cells.

Apoptosis↗
PubMed1993

Aggressive pulmonary metastasectomy for soft tissue sarcomas.

BACKGROUND: To evaluate the efficacy of aggressive pulmonary metastasectomy for treating soft tissue sarcomas, the clinical data on the surgical management of 23 patients with extensive pulmonary metastases from soft tissue sarcomas were reviewed. METHODS: Between January 1973 and April 1991, 9 male patients and 14 female patients were treated. Their ages ranged from 13-68 years (median, 42 years). Twenty-one patients (91%) had bilateral and multiple metastases, and two patients had solitary metastasis. The number of resected metastatic nodules ranged from 1-110 (mean, 30.5). As an initial surgical approach, median sternotomy was used on 18 patients and lateral thoracotomy on 5 patients. Eleven patients underwent two or more explorations for recurrent metastases using lateral thoracotomy. The neodymium:yttrium-aluminum-garnet (Nd:YAG) laser was adopted in 10 patients since 1986. RESULTS: The actuarial 2-year and 5-year survival rates after the first pulmonary resection were 49.7% and 24.8%, respectively. Histologic type (alveolar soft part sarcoma versus synovial sarcoma, P < 0.025), histologic grade (G1 and G2 versus G3, P < 0.01), and metastatic localization (subpleural versus extrapleural, P < 0.005) were the most significant prognostic factors for aggressive pulmonary metastasectomy of soft tissue sarcomas. Application of laser surgery, absence of local recurrences, and absence of extrapulmonary metastases before pulmonary resection also correlated with better prognosis with borderline significance. CONCLUSIONS: Aggressive pulmonary metastasectomy for soft tissue sarcomas is a recommended procedure, even in the case of extensive metastases. The combination of median sternotomy and Nd:YAG laser-assisted surgery is a useful technique, especially in bilateral multiple pulmonary metastases.

Adolescent↗
PubMed1993

Non-universal decoding of the leucine codon CUG in several Candida species.

It has been reported that CUG, a universal leucine codon, is read as serine in an asporogenic yeast, Candida cylindracea. The distribution of this non-universal genetic code in various yeast species was studied using an in vitro translation assay system with a synthetic messenger RNA containing CUG codons in-frame. It was found that CUG is used as a serine codon in six out of the fourteen species examined, while it is used for leucine in the remaining eight. The tRNA species responsible for the translation of codon CUG as serine was detected in all the six species in which CUG is translated as serine. The grouping according to the CUG codon assignments in these yeast species shows a good correlation with physiological classification by the chain lengths of the isoprenoid moiety of ubiquinone and the cell-wall sugar contained in the yeasts. The six Candida species examined in which CUG is used as serine belong to one distinct group in Hemiascomycetes.

Amino Acid Sequence↗
PubMed1993

The primary structures and properties of non-stomach lysozymes of sheep and cow, and implication for functional divergence of lysozyme.

Lysozymes were purified from the homogenate of cow and sheep kidneys, and their amino-acid sequences as well as some enzymic properties were determined. Like most mammalian lysozymes both sheep and cow kidney lysozymes are composed of 130 amino acids. The sequences of these two lysozymes are the most similar to each other (95% identity), the second most similar to the conventional mammalian lysozymes like human, rat and rabbit lysozymes (74-85% identity), and much less similar to their own stomach lysozymes (65-70% identity). Cow kidney lysozyme is also different from cow milk lysozyme (partial sequence), indicating that cow contains at least three kinds of chicken type lysozymes, that is kidney, milk and stomach lysozymes. The activities of cow and sheep kidney lysozymes were 3% and 29% against Micrococcus luteus at pH 7.0, ionic strength of 0.1 and 30 degrees C, and 57% and 84% against glycol chitin at pH 5.5 and 40 degrees C, which were expressed as percentages relative to hen lysozyme. The net charges of cow and sheep lysozymes at pH 7 were less positive (+1.5 and +2.5, respectively) than human and hen lysozymes (both +8.0) and rather close to the stomach ones (-2 to 0). The decreased net positive charge observed in cow and sheep kidney lysozymes may suggest that the ruminant kidney lysozyme had functioned once as a digestive enzyme in the stomach of an ancestral ruminant.

Amino Acid Sequence↗
PubMed1993

Prognostic significance of bone metastases in patients with metastatic prostate cancer.

BACKGROUND: The distribution of bone metastases on a bone scan has not been duly considered when assessing the prognosis of metastatic prostate cancer. METHODS: The medical records of 76 patients with newly diagnosed, untreated metastatic prostate cancer were reviewed. According to the distribution of bone metastases on the initial bone scan, we divided the patients into three groups: Group I (having bone metastases exclusively within the pelvis and the lumbar spine), Group II (having bone metastases exclusively outside these bones), and Group III (having bone metastases in both areas). RESULTS: Among the responders to androgen deprivation, those in Group I survived significantly longer than did those in Groups II or III. Because the extent of the disease and the distribution of histologic differentiation in Groups I and II were similar, the results indicate that the presence of bone metastases outside the pelvis and the lumbar spine is predictive of short survival time. This prediction was not possible when the extent of disease (EOD) grading system was used. CONCLUSION: The distribution of bone metastases on the initial bone scan should be considered as a variable for the prognostic stratification of patients with metastatic prostate cancer.

Adenocarcinoma↗