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Biomedical subjects

Y Akama

Publications and source records attributed to Y Akama.

At least 37 records · Page 2Linked to original sources
PubMed1994

Frequent loss of heterozygosity of the long arm of chromosome 7 is closely associated with progression of human gastric carcinomas.

Loss of heterozygosity (LOH) on the long arm of chromosome 7 was examined using 5 polymorphic marker probes on 98 gastric carcinomas to elucidate a novel locus for development and progression of the tumors. Twenty-six (32%) of 82 informative cases showed LOH on 7q on at least one locus of 5 loci. Among 5 loci, LOH at D7S95 locus was most frequent, the incidence being 53% in well-differentiated gastric carcinomas and 33% in poorly differentiated and scirrhous gastric carcinomas respectively. At 3 loci, c-met, D7S63 and D7S22, the incidence of LOH was about 30% and 10% in well-differentiated and poorly differentiated gastric carcinoma cases respectively. In contrast, LOH at D7S64 was not detected in any gastric-carcinoma cases. Deletion mapping of 7q revealed that D7S95 locus was the essential region of LOH. Eight (62%) of 13 cases with LOH at D7S95 locus belonged to the most advanced stage grouping. Furthermore, 6 (75%) of 8 cases with abdominal dissemination showed LOH at D7S95. Therefore, cases with LOH at D7S95 showed significantly worse prognosis than the cases without the LOH in the stage-III and stage-IV groups. These findings overall suggest that D7S95 locus on 7q may contain a candidate suppressor gene for the progression of gastric carcinoma.

Adenocarcinoma↗
PubMed1994

[Amount of mercury from dental amalgam filling released into the atmosphere by cremation].

Mercury in dental amalgam filling is released into the atmosphere by cremation and is a suspected source of mercury pollution. The amount of mercury released was measured at three crematoriums. First, mercury levels in the atmosphere were measured. Mercury existed mainly in the gaseous form in ambient air. The concentration of atmospheric mercury at the three crematoriums (S, T and M) ranged from 4.3 to 19.7ng/m3, which was nearly identical to levels in our university surveyed as the control area and also to the levels of atmospheric mercury in general in Japan. Secondly, the amount of mercury release from T crematorium was estimated using official published statistical data in Japan and calculated as follows: sigma[(age specific number of dead that were cremated) x (the number of restored teeth by age category) x (mercury content per amalgam filling (0.6 g))] x (prevalence rate of restoration with amalgam). The amount of mercury released from this crematorium was estimated to be approximately 9.4 kg per year, or a daily release of 26 g into the ambient air. These results indicate that mercury release by cremation is similar to that from other man-made sources.

Air Pollutants↗
PubMed1994

[Problems of epidural droperidol administration].

We describe three cases of extrapyramidal reactions apparently caused by epidural administration of droperidol. These patients suffered from chronic pain and was treated with epidural lidocaine and droperidol. Two patients received continuous administration of droperidol, and experienced acute dystonia and another after a single dose, developed akathisia. Adverse reactions occurred at 15, 20 and 24 hours after the administration of droperidol. The first patient received droperidol 6 mg, the second 8.5 mg and the third 5 mg. We consider that extrapyramidal reactions are due to overdoses because the patients who had been given less than 2.5 mg of droperidol a day, showed no adverse reaction. Although we use higher doses with NLA or for management of fever than with epidural administration of droperidol, we seldom encounter cases of side effects with droperidol. Epidurally administrated droperidol spreads rostral within the neuraxis and causes delayed extrapyramidal reactions as epidural morphine develops delayed respiratory depression. We must be careful in caring patients suffering from chronic pain with continuous epidural administration of droperidol.

Adult↗
PubMed1994

Clavicular approach to intraosseous infusion in adults.

We attempted a clavicular approach to intraosseous infusion (clavicular IO) as a new procedure in adults, and compared the flow rates of subclavian venous infusion, and clavicular, iliac and tibial IO. Furthermore, we observed enhanced roentgenograms of each IO by contrast media. As a result, clavicular IO indicated 11.9 +/- 0.68 mL/kg/hr (mean +/- SD, n = 29), iliac IO 32.2 +/- 4.48 (n = 21), tibial IO 18.9 +/- 1.28 (n = 15), and subclavian venous infusion 15.2 +/- 1.48 (n = 15). There were no statistically significant differences between subclavian venous infusion and clavicular IO. In roentgenograms, the contrast media entered the inferior vena cava from iliac IO, and via the femoral vein by tibial IO. The superior vena cava was enhanced through the subclavian vein in clavicular IO. No complications such as fractures or transclavicular penetrations by the IO needle occurred. In conclusion, clavicular IO may be an alternative infusion technique to provide the fluids into the subclavian vein in adults.

Aged↗
PubMed1993

Systematic management of graft-versus-host disease (GVHD).

Patients with graft-versus-host disease (GVHD) develop multiple organ failure (MOF), so systematic management is needed. First, patients should be kept in a clean room. Antibiotics, anti-fungal drugs and gamma-globulins are essential for the prevention and treatment of infections. If patients are hypoxic for the nasal cannula or the mask, continuous positive airway pressure (CPAP) or artificial ventilation must be used. In the treatment of hepatic dysfunction, lactulose, branched chain amino acid, glucagon-insulin, and Prostaglandin E1 (PGE1) are given. If plasma exchanges are ineffective, a bilirubin absorption therapy may remain partially effective. In the treatment of renal failure, diuretics, PGE1 and dopamine are given. Hemofiltration and hemodialysis will be effective. But the effective treatment for post-transfusion GVHD is unavailable, so systematic management of GVHD is no more than allopathic treatment.

Bone Marrow Transplantation↗
PubMed1993

[P50, 2,3-diphosphoglycerate and sodium as well as potassium in red blood cells in the perioperative period after hemodilutional autotransfusion].

The changes of the P50, 2,3-DPG and sodium as well as potassium of red blood cells in perioperative period were studied in 12 patients who underwent hemodilutional autotransfusion (HAT). P50 and 2, 3-DPG did not show remarkable changes before the third day after operation, but increased significantly on 5th and 7th day. There was a positive correlation between P50 and 2,3-DPG. Potassium of red blood cell increased significantly except on the first day. But sodium of red blood cell showed no remarkable change. In conclusion, our data demonstrate that the tissue oxygen supply from the red blood cell is maintained, because P50 did not decrease. Sodium in the red blood cell does not show remarkable changes, and therefore the membrane function of the red blood cell should be kept intact.

2,3-Diphosphoglycerate↗
PubMed1993

[Study of combined hepatocellular and cholangiocarcinoma].

Four patients with combined hepatocellular and cholangiocarcinoma were studied. One case received hepatic arterial infusion therapy (HAIT), 2 hepatectomy and the case with extrahepatic cholangiocarcinoma underwent enucleation. According to Allen's classification, two were combined type and the others mixed type. Tumor ploidy patterns on flow cytometric DNA analysis were aneuploid in 2 cases with curative resection, of which one is still alive 6 years and 3 months after surgery. It suggested that the patient's survival was affected by the pathological factors more than the ploidy patterns of the tumor. A case treated by HAIT improved considerably in terms of symptoms and evidenced reduction in the size of the deposits. Selection of anticancer agents sensitive to both hepatocellular and cholangiocarcinoma is required.

Adenoma, Bile Duct↗
PubMed1993

[Predicting the difficulty of laryngoscopy using the distance between the lower border of the mandible and the thyroid notch].

We examined the relationship between the degree of difficulty in visualization of the larynx and the distance from the lower border of the mandible to the thyroid notch (M-T distance). Patients were examined and the M-T distance was measured with their neck fully extended during preoperative period. Difficulty of laryngoscopy was graded as reported previously. Five hundred sixty one patients were assessed, and those with obvious neck and head pathology were excluded. There were 440 cases (78.4%) in grade 1, 116 cases (20.7%) in grade 2 and only 5 cases (0.9%) in grade 3. There were no grade 4 cases. The M-T distance was 5.4 +/- 0.6 cm in grade 1, 4.6 +/- 0.7 cm in grade 2 and 3.6 +/- 0.7 cm in grade 3. These were significantly different with each other (P < 0.05). If the M-T distance is 4.5 cm or less, the difficulty in visualization of laryngoscope increases. Therefore, in the case in which the M-T distance is 4.5 cm or less, we recommend further examination and preparation for difficult laryngoscopy.

Forecasting↗
PubMed1993

[Intrapleural regional analgesia in pain management after chest trauma].

Twelve chest trauma patients with severe pain were studied. All of them had multiple rib fractures, hemopneumothorax or pulmonary contusion, and needed the continuous chest drainage. 16 G epidural block catheter was introduced 20 cm into the apex of the pleural space. Furthermore, another catheter was placed into the base of the pleural space. After injecting 1% lidocaine 10 ml, the analgesic effect, the analgesic range according to injected point (apex or base), and the changes of vital signs, PaO2/FIO2 and PaCO2 were evaluated. The average pain scale before interpleural regional analgesia (IPA) was 2.9 and 1.0 after 15 min. The time to return to pre-IPA condition took about 150 min. The mean blood pressure did not show significant changes, although pulse and respiratory rate decreased. PaCO2 did not show significant changes, although PaO2/FIO2 increased significantly. The present study indicates that IPA in chest trauma reduces pain and improves PaO2/FIO2 significantly without circulatory changes. It was reported that it was difficult to obtain effective pain relief after thoracotomy. However, when the catheter is placed at the apex, it seems to be effective to relief pain on the chest site. In conclusion, IPA seems to be simple, effective and useful to remove pain from chest trauma when epidural block is difficult to induce.

Adolescent↗
PubMed1992

[A study of postoperative respiratory function].

The purpose of this study is to investigate the causes of postoperative respiratory failure from the point of view of respiratory movement and respiratory function, using a respigraph. Thirty patients who had laparotomy, thoracotomy or both were studied. A-aDo2 increased after operation. The values recovered slowly in the order of thoracotomy, laparotomy, was thoraco-laparotomy group. Percent vital capacity (% VC), one second timed force expiratory volume (FEV1), and peak expiratory flow (PEF) were suppressed immediately after operations and increased slowly, but showed still lower values even on the 7th day. VT, V min, f, TI/TT, VT/TI and PaCO2 were almost at the same levels among the three groups. Percent rib cage (% of RC) increased and remained high on the 7th day after laparotomy and thoraco-laparotomy, but showed no remarkable changes after thoracotomy. Between A-aDo2 and % RC in laparotomy group, there was a good correlation. Not only FRC but also the change of % RC seemed to have caused postoperative hypoxemia. The movement of the abdomen affected respiratory dysfunction more than the movement of the thorax after thoracic and abdominal surgery.

Aged↗
PubMed1992

[Clinical examination of acetated Ringer solution in patients with normal liver function and those with liver dysfunction].

Acetated Ringer solution (AR) was studied clinically to find its usefulness in patients with liver dysfunction compared with lactated Ringer solution (LR). The thirty-eight patients scheduled to be operated were divided into four groups (Group I: with normal liver function and AR infused, Group II: with normal liver function and LR infused, Group III: with liver dysfunction and AR infused, Group IV: with liver dysfunction and LR infused). AR or LR was administered to each group at a speed of 10 ml.kg-1.h-1, and we investigated the differences of these four groups clinically. L-lactic acid increased significantly in all groups after administration of AR or LR. D-lactic acid increased in LR groups, and acetic acid increased in AR groups. However, the other parameters, including the acid-base balance, electrolytes and liver function, showed no significant changes in any group. Therefore the status of liver dysfunction did not affect the metabolism of lactic acid in this study. These findings indicate that as an intraoperative fluid, AR is just as useful as LR. However, there was no significant difference between the data of AR groups compared with those of LR groups. In conclusion, AR is not necessarily a better fluid compared with LR as an intraoperative fluid in patients with liver dysfunction.

Adult↗
PubMed1991

[Effects of mannitol on the function of red blood cells].

The effects of mannitol on the function of red blood cell were studied in 12 neurosurgical patients for 4 hours after intravenous administration of 2 g.kg-1 mannitol taking 30 min. After the administration of mannitol, osmotic pressure, Na and K in serum and of red blood cell were all altered. P50, 2, 3-DPG rose gradually and red blood cell deformity improved significantly. These results indicate that mannitol can shift oxyhemoglobin dissociation curve rightward, improve red blood cell deformity, and increase tissue oxygenation significantly. Mannitol administration not only decreases intracranial pressure but also improves peripheral circulation and oxygen transport during brain resuscitation.

Adult↗
PubMed1990

[Change of renal function immediately after angiography].

Abdominal angiography using ioxaglate (3.0-4.5 ml/kg) was performed in 10 patients with normal renal function. Ccr, FENa, CH2O were compared before and immediately after angiography. There was no significant change in Ccr and CH2O level, while FENa increased remarkably after angiography. This study suggested that the osmotic diuresis and the proximal tubular stress were induced by administrated low osmolality contrast material during conventional abdominal angiography.

Aged↗
PubMed1989

[Properties of dental cyanoacrylate cement "FH" in the early period of setting].

The properties of dental cyanoacrylate cement "FH", which has protective and bacteriostatic effect on dental pulp, were compared with that of glass-ionomer cement. The operational properties such as setting time and consistency were good, but the mechanical properties as dental cement were a little inferior. These properties were affected definitely by temperature and humidity than the glass-ionomer cement, especially the influence of humidity was very high. However, the influence on bond strength was almost nothing, especially in the early period of setting. The factors affecting it could be very low disintegration. The bond strength for dentin after 24 hours the start of mixing of FH cement was much higher than that for enamel, but the strength rapidly decreased by thermal cycling between 4 degrees C and 50 degrees C in water.

Cyanoacrylates↗