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T Ueda

Publications and source records attributed to T Ueda.

At least 145 records · Page 8Linked to original sources
PubMed1999

[Coronary artery bypass surgery in octogenarian].

Between May 1992 and December 1997, 14 parents aged 80 or older underwent CABG with cardiopulmonary bypass. (Group A: mean age 82.1 +/- 1.73). This group was compared with 127 patients aged 70s. (Group B: mean 73.3 +/- 0.70). Left main trunk stenosis was more frequent in group A (p < 0.05), and number of patient who had old myocardial infarction was also frequent (p < 0.05). Emergency operation and preoperative use of intra aortic balloon pump was frequent in group A (p < 0.05). While there was no significant change in the number of graft per patient and used number of internal thoracic artery between the two groups, postoperative complications such as atrial arrhythmia and respiratory failure was appeared more frequently in group A (p < 0.05). The hospital mortality did not differ between the groups (21.4% for group A and 14.2% for group B). In group A, 11 patients are alive without recurrence of angina. In conclusion, while there is many problems pre and post operative term, CABG in over 80 years patients of age was satisfactory result, so we should not exclude octogenarian because of age alone.

Aged↗
PubMed1999

Apoptotic cell death of renal tubules in experimental severe acute pancreatitis.

BACKGROUND: Recently renal cell apoptosis has been reported in various disorders that result in renal failure. Thus we hypothesized that renal cell injury resulting from apoptosis is involved in renal failure with severe acute pancreatitis. METHODS: Renal cell apoptosis in kidneys harvested from rats with necrotizing pancreatitis was evaluated by in situ nick-end labeling. Ascitic fluid that had been collected 6 hours after development of pancreatitis was injected into the peritoneal cavities of healthy rats, and renal apoptosis was also evaluated. The apoptosis-inducing activity of the ascitic fluid was estimated in vitro with use of isolated rat renal tubules and the normal rat kidney cell line NRK52E by nuclear staining, cell cycle analysis, and DNA electrophoresis. RESULTS: Apoptosis was detected by in situ nick-end labeling on the renal tubules 6 hours after induction of pancreatitis in vivo. Similar tubular apoptosis was detected in the rats that had intraperitoneal injection of the ascitic fluid. In in vitro analyses the ascitic fluid induced nuclear and DNA fragmentation on the isolated renal tubules and promoted apoptosis on NRK52E cells in a time-dependent manner. CONCLUSIONS: Apoptotic cell death of renal tubules occurs in severe acute pancreatitis within several hours and is possibly involved in the mechanism of renal failure through undefined substance(s) in the ascitic fluid associated with pancreatitis.

Animals↗
PubMed1999

Successful salvage treatment with irinotecan (CPT-11) of recurrent malignant lymphoma in an aged patient; and CPT-11 pharmacokinetics.

A 72-year-old patient with relapsed non-Hodgkin's lymphoma (diffuse large B-cell type) in the tongue was treated with irinotecan (CPT-11) as the 4th salvage therapy. A two-thirds reduced dose of 40 mg/m2 of CPT-11 was administered, as were granulocyte-colony stimulating factor and antidiarrheal agents. Complete remission was achieved. Although grade 3 leukopenia and grade 1 diarrhea were observed, these adverse reactions did not interrupt the treatment schedule and CPT-11 was administered without interruption for a total of 12 weeks. Despite the dose reduction, the area under the concentration-time curve of SN-38, the active metabolite of CPT-11, was nearly equal to the values reported in phase I and II studies of CPT-11. The patient's ratio of SN-38 to the SN-38 glucuronide (SN-38G) was low, suggesting a low risk of diarrhea. The optimal dose modification provided a sufficient amount of the active metabolite. Supportive therapy managed therapy-related toxicities and resulted in a stable treatment schedule. This is a rare case of a patient successfully treated with CPT-11 after a 4th relapse, in which the agent was administered at the total dose of 960 mg/m2, despite the patient's advanced age.

Aged↗
PubMed1999

[Early postoperative results of coronary revascularization with the radial artery: an analytical study of vascular diameter ratio of the graft and the coronary artery].

Between October 1996 and June 1988, radial artery grafts were used in 49 patients undergoing myocardial revascularization. There were three hospital deaths, none of them due to the use of radial artery. In 32 patients studied early, 33 of 34 radial artery grafts were patent (patency 97%), and 30 of 32 internal thoracic artery grafts (94%), 32 of 35 saphenous vein grafts (90%), 3 of 3 gastroepiploic artery grafts (100%) were patent respectively. The mean diameter ratio of graft and recipient coronary artery was 1.03 +/- 0.17 in radial artery, 0.92 +/- 0.16 in internal thoracic artery and 1.67 +/- 0.55 in saphenous vein graft. Our result suggest that the radial artery is an excellent conduit for myocardial revascularization, although a longer follow-up is mandatory.

Adult↗
PubMed1999

[Usefulness of 18F-FDG PET for diagnosis of cardiac sarcoidosis].

Cardiac sarcoidosis, the main cause of death among patients with sarcoidosis, frequently becomes clinically apparent when the disease is far advanced. To evaluate the usefulness of the 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) in detecting cardiac sarcoidosis, 18F-FDG PET was performed in 16 patients with sarcoidosis (13 female, 63 +/- 12 yrs), compared with scintigraphic findings of 99mTc-MIBI and 67Ga. Ten of 16 patients were considered to have cardiac complications on clinical grounds with tissue confirmation such as positive endomyocardial biopsy, severe ventricular arrhythmia, more than second degree atrioventricular block, and echocardiographically proven ventricular dysfunction. Among these patients with cardiac complications, abnormal myocardial uptake of FDG were observed in all (100%), which confirms significantly higher frequency compared to 67Ga scintigraphy (50%) (abnormality of 99mTc-MIBI SPECT were observed in 80%). Although abnormal FDG accumulations were observed in region with decreased uptake of 99mTc-MIBI in many cases, localization of regional abnormality of each tracer was frequently independent. This discrepancy may reflect inflammatory and degenerative process of myocardium in cardiac sarcoidosis. 18F-FDG PET is thought to be a useful noninvasive method in detecting cardiac involvement of sarcoidosis and may provide a useful information on the activity of the disease.

Adult↗
PubMed1999

Successful treatment of cytomegalovirus retinitis in a patient with malignant lymphoma: a case report and review of the literature.

A 52-year-old Japanese woman was diagnosed as having angioimmunoblastic T-cell lymphoma (stage IV-B). She received 6 courses of chemotherapy including cyclophosphamide, doxorubicin, vincristine, and prednisolone every two weeks (biweekly CHOP), and was considered to be in partial remission. She complained of loss of visual acuity in her right eye during her last cycle of chemotherapy. Cytomegalovirus (CMV) retinitis was suspected from the characteristic ophthalmoscopic appearance. This diagnosis was further supported by the detection of CMV DNA in blood and antigens in polymorphonuclear leukocytes, a sign of CMV reactivation. Although DNAemia and antigenemia became negative, retinitis remained slightly active despite a 4-week systemic treatment of ganciclovir. Intraocular injection of ganciclovir was started and continued until the retinitis became inactive ophthalmoscopically. The patient received high-dose chemotherapy with peripheral blood stem cell transplantation and achieved complete remission. During the after this therapy no recurrence of CMV infections was observed. This case shows that 1) a quick and accurate diagnosis of CMV retinitis was possible by applying DNAemia and antigenemia and 2) intensive treatment for the CMV infection enabled the accomplishment of cure-oriented chemotherapy of the lymphoma without the recurrence of CMV retinitis.

Cytomegalovirus Retinitis↗
PubMed1999

Variations in the gene for vacuolating toxin, vacA, in Japanese isolates of Helicobacter pylori.

Each of 284 strains of Helicobacter pylori which had been isolated in Japan was shown, by use of the polymerase chain reaction (PCR), to be positive for the vacA genes. The amplified vacA genes generated by PCR were classified into six classes (five for the clinical isolates, and one which corresponded to the standard strains). Endoscopic analysis revealed that cases of gastritis were most likely to be associated with class D, while none were associated with class A. The patterns of products of PCR obtained from the Japanese isolates were compared with theoretical patterns derived from sequences of vacA which had been reported previously. The nucleotide sequences of amplified fragments of vacA from representative strains in each class were determined and compared with those of previously reported vacA genes.

Bacterial Proteins↗
PubMed1999

[Emergency coronary artery bypass grafting for acute coronary syndrome].

Emergency CABG for acute coronary syndrome (ACS) was studied. Sixty patients had CABG for medically refractory UAP, 78 patients for AMI and 8 patients for post-infarction angina (PIA). In UAP group 7 patients (12%) died postoperatively, mainly due to perioperative myocardial infarction (PMI) and operative complications. In AMI group, 26 patients (33%) died, 14 of them due to myocardial failure. The operative mortality was extremely high in shock-state patients group (48%) and cardiac pulmonary arrest state patients group (85%). Operative result was poor in those patients whose infarct-related artery was not recanalized preoperatively. Operative mortality was 13% in PIA group. It was concluded that the reduction of mortality of those patients required much refined myocardial preservation technique and powerful mechanical assist system to support the postoperative myocardial failure.

Aged↗
PubMed1999

[Emergency coronary artery bypass grafting for ischemic heart disease].

Between June, 1988 and May 1998, 524 patients underwent isolated coronary artery bypass grafting (CABG) utilizing cardiopulmonary bypass in our institution. The 74 patients who underwent CABG on emergency surgery were subjected in this study. Age was ranged 33 to 89 years (mean 65 +/- 1.1; 50 male, 24 female). Of 74 cases, 52 cases underwent emergency CABG due to UAP, and 22 cases were AMI. The hospital mortality rate in 74 cases was 19% (15/74) and 2.4% (11/450) in patients who had scheduled CABG (p < 0.0001). Mortality rate in AMI group was 41% (9/22) and 9.6% (5/52) in UAP (p < 0.005). Number of patients aged 75 years or elder was 14 (19%) in emergency CABG, and 43 (8.9%) in scheduled CABG (p < 0.05). To improve the operative results of emergency CABG, it is important to reduce the number of emergency CABG in elderly, by the careful diagnosis and aggressive surgical treatment as same as in younger patient.

Adult↗
PubMed1999

Identification of a I-cM region of common deletion on 13q14 associated with human prostate cancer.

Frequent allelic losses on chromosome arm 13q are observed in carcinomas of the head and neck, breast, ovary, and pituitary gland. We analyzed 59 primary prostate tumors (stage B, 18 patients; C, 12 patients; D1, 4 patients; and endocrine therapy-resistant cancer death, 25 patients), as well as 18 metastatic tissues from 14 of the 25 cancer death patients for loss of heterozygosity (LOH) using 35 microsatellite markers on chromosome arm 13q. Of the 59 primary tumors, 31 (53%) showed LOH involving at least one locus. Detailed deletion mapping identified a distinct commonly deleted region in the I-cM interval flanked by D13S153 and D13S273 on 13q14 and this region overlapped a part of the RB1 gene. Paired DNAs were available from both primary and metastatic tumors in the 14 cases of cancer death; among those pairs, we detected LOH on 13q in seven (50%) primary tumors, and in all metastatic foci (P = 0.0029). Moreover, the regions lost in metastatic tissues were more extensive than those seen in the corresponding primary tumors. These results suggest that inactivation of a putative tumor suppressor gene(s) including the RB1 gene on 13q14 plays an important role in human prostate cancer.

Adrenal Gland Neoplasms↗
PubMed1999

[Penile carcinoma with humoral hypercalcemia of malignancy (HHM): a case report].

A 57-year-old male, with 1.5 cm tumor in his prepuce, was admitted to our institute in Feb. 1990. Circumcision and inguinal lymph node dissection was performed under the diagnosis of T1 disease of penile carcinoma. Pathological evaluation revealed well-differentiated squamous cell carcinoma (SCC). In April 1996, the patient revealed recurrence of the disease in the right inguinal lymph nodes and the lower abdomen, that was diagnosed to be poorly differentiated SCC. Laboratory findings showed elevation of serum calcium, parathyroid hormone-related protein (PTHrP) levels. Immunohistochemical staining confirmed production of PTHrP in the tumor tissue. This is the first case report of penile carcinoma that caused humoral hypercalcemia of malignancy in Japan.

Carcinoma, Squamous Cell↗
PubMed1999

[A case who needed additional Daggett's procedure for residual shunt after infarction exclusion technique for post-infarction ventricular septal perforation].

A 71-year-old woman had the surgical repair of post-infarction ventricular septal perforation with infarction exclusion technique. Three days after operation, residual shunt was observed by echocardiogram and she developed cardiac failure. Pulmonary to systemic flow ratio was 2.1, and pulmonary artery pressure was 42/23 (33) mmHg. Additional surgery for residual shunt was performed 22 days after the first operation. The part of Xenomedica patch was found loosely floating in the LV cavity. The infarcted myocardium was firm enough to closed directly, so a double Hemashield cardiovascular fabric was sutured on the left side of the perforated septum around VSP (Daggett's Procedure). The ventriculotomy was closed including the fabric with two felt strips. The postoperative course was uneventful. Though infarction exclusion technique has the advantage in many cases, much attention must be paid to prevent residual shunt.

Aged↗
PubMed1999

Distribution and intracellular localization of a mouse homologue of Ca2+/calmodulin-dependent protein kinase Ibeta2 in the nervous system.

Ca2+/calmodulin-dependent protein kinases (CaMKs) are believed to play important roles in the development and function of the nervous system. We report here the identification and expression of mouse CaMKIbeta (mCaMKIbeta), in particular mCaMKIbeta2, an isoform of mCaMKIbeta. During embryogenesis, the mCaMKIbeta2 gene is expressed mainly in the nervous system, including brain, spinal cord, trigeminal ganglion, and retina. Within the CNS, the expression of mCaMKIbeta2 is detected in the mantle zone, but not in the ventricular zone, suggesting its possible involvement in the differentiation of neurons. In the adult brain, mCaMKIbeta2 transcripts are detected at high levels in the anterior olfactory nuclei, piriform cortex, septal nuclei, bed nuclei of the stria terminalis, hippocampal pyramidal cells, dentate granule cells, amygdala, hypothalamic nuclei, parabrachial nucleus, and nucleus of the solitary tract. The distinct gene expression pattern suggests that mCaMKIbeta2 may also be involved in different mature neuronal functions from other CaMKs. In addition, mCaMKI/beta2 proteins are localized to the cytoplasm and nuclei, but not to nucleoli, suggesting that mCaMKIbeta2 proteins might be involved in the cytoplasmic and nuclear signal transduction of the nervous system.

Amino Acid Sequence↗
PubMed1999

Hepatic tumor rupture following effectual treatment with irinotecan in a patient with highly refractory malignant lymphoma.

We describe a patient with highly refractory malignant lymphoma who died of hepatic tumor rupture following treatment with irinotecan (CPT-11). This 60-year-old man with non-Hodgkin's lymphoma (diffuse large B-cell lymphoma) demonstrated disease recurrence in the liver and the vertebrae following high-dose chemotherapy and autologous hematopoietic stem cell transfusion. He was treated with CPT-11 at a dose of one third of the conventional dose used for non-Hodgkin's lymphoma in Japan. The tumor in the liver markedly decreased in size but then ruptured. Although pathologic hepatic tumor rupture is a rare complication in patients with malignant lymphoma of the liver, this case demonstrates that hepatic tumor rupture may occur in refractory malignant lymphomas that reveal extensive degradation by this new, effective salvage therapy.

Antineoplastic Agents, Phytogenic↗
PubMed1999

Doppler echocardiographic evaluation of the hemodynamics in absent aortic valve.

Hemodynamics were estimated by Doppler echocardiography in a neonate with an absent aortic valve and absent or extremely hypoplastic mitral valve. The coronary blood flow depended on the increased end-diastolic pressure of the left ventricle. Pulmonary venous congestion, which was also due to the increased end-diastolic pressure of the left ventricle, may induce decreased oxygen saturation and, subsequently, further myocardial hypoxia, poor contraction and increased end-diastolic pressure of the left ventricle. Finally, hypoxic blood was supplied to each organ from the pulmonary artery through the ductus arteriosus, which induced severe acidosis and differential cyanosis after birth.

Aortic Valve↗
PubMed1999

Intraoperative extracorporeal autogenous irradiated bone grafts in tumor surgery.

There are several procedures for reconstruction of bony defects after resection of malignant musculoskeletal tumors. The clinical results of intraoperative extracorporeal autogenous irradiated bone grafts in 20 patients with musculoskeletal tumors are discussed. The authors' method of treatment consists of: (1) wide en bloc resection of the tumor with involved bone; (2) curettage of the tumor from the resected bone; (3) extracorporeal irradiation with 50 Gy as a bolus single dose to the isolated bone; and (4) reimplantation of the irradiated bone into the host with fixation devices. Twelve bone sarcomas and eight soft tissue sarcomas with bone involvement were treated surgically with this reconstruction method after wide resection of the tumors. The irradiated bone was used as an intercalary graft in seven cases, as an osteoarticular graft in 11 cases, and as a hemicortical graft in two cases. The theoretical advantages of this method are certain sterilization of tumor cells with radiation, easy availability and good adaptation of size and shape, no risk of disease transmission, preservation of bone stock and ligamentous tissue, and no immunologic reaction. Radiologically, bony union occurred in 23 of 29 (79%) osteotomy sites. The overall radiographic evaluation rating was 74% and the functional rating was 73% according to the International Society of Limb Salvage rating system. Nonunion (20%) and infection (15%) were the two major complications. Preservation of the tendon insertions and ligamentous structures of the irradiated bone seemed to restore excellent joint function. No local recurrence was detected from the irradiated bones during the mean followup of 45 months. These results indicate intraoperative extracorporeal irradiated bone graft can be a widely applicable method for reconstruction in tumor surgery.

Adolescent↗