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Biomedical subjects

A Watanabe

Publications and source records attributed to A Watanabe.

At least 613 records · Page 34Linked to original sources
PubMed1992

[Usefulness of 99mTc-ECD SPECT in diseases of the central nerve system: special reference to a comparison with 123I-IMP and 99mTc-HM-PAO SPECT].

The usefulness of a new cerebral perfusion imaging radiopharmaceutical, 99mTc-ethyl cysteinate dimer (ECD), was clinically evaluated. The subjects of this study were 14 patients with neurological disorders including 10 patients with cerebral infarction and 4 patients with other diseases. A total of 15 examinations was performed. 99mTc-HM-PAO or 123I-IMP SPECTs were performed simultaneously, and the findings from those examinations were compared with 99mTc-ECD. As to the count ratio of lesions to normal area (L/N), the L/N ratio in severe ischemic patients was lower in 99mTc-ECD than in 99mTc-HM-PAO or 123I-IMP. In mild ischemic patients, on the other hand, the L/N ratio was the lowest in 123I-IMP. When the relationship between rCBFs obtained from 123I-IMP and the values of L/N in 99mTc-ECD or 99mTc-HM-PAO was compared, the values of L/N in 99mTc-ECD or 99mTc-HM-PAO were found to have decreased linearity with increasing rCBF. In a patient showing luxury perfusion, the accumulation pattern of 99mTc-ECD was different from that of the other two radiopharmaceuticals, and focal defect was revealed in 99mTc-ECD SPECT. On the dynamic SPECT of 99mTc-ECD in a patient with meningioma, the tumor showed a change from high to low perfusion with the passage of time. This finding indicated that care should be taken in the evaluation of accumulation of 99mTc-ECD. Therefore, 99mTc-ECD was found to be useful as a cerebral perfusion agent. In addition, as accumulation of 99mTc-ECD might somehow reflect metabolism in some cases, further careful investigation of many cases should be carried out.

Adult↗
PubMed1992

[The beta-lactamase activity in methicillin-resistant Staphylococcus aureus--a comparison of the beta-lactamase from a methicillin-resistant and from a methicillin-sensitive strain of Staphylococcus aureus].

Strains of Methicillin-resistant Staphylococcus aureus (MRSA) are more frequently beta-lactamase-negative than those of Methicillin-susceptible S. aureus (MSSA). In the strains of MRSA, the beta-lactamase activity tends to be inversely related to the MIC's of Methicillin. Such a marked tendency has been observed in recent years.

Methicillin↗
PubMed1992

[Effective single and combined chemotherapeutic regimens as regards to antibiotic resistance patterns of methicillin-resistant Staphylococcus aureus (MRSA) in Japan].

The incidence of gentamicin-resistant MRSA (GMr-MRSA) has been gradually increasing since early 1980's in Japan. The GMr-MRSA mainly belongs to Group-I phage type and to Group-IV coagulase type. It is rather difficult to induce methicillin-resistance in the GMr-MRSA in the presence of beta-lactam antibiotics. Since late 1980's tobramycin-resistant MRSA (TOBr-MRSA) has been increasing rapidly in place of GMr-MRSA. The TOBr-MRSA mostly belongs to Group III phage type and Group II coagulase type. It rapidly acquires resistance to methicillin and becomes highly resistant to many other related antibiotics as evidenced by statistics in 1980's in Japan. A combination chemotherapy with imipenem/cilastatin and 1st or 2nd generation cephem, or minocycline plus cephem is considered to be effective for MRSA infections. However, a combination chemotherapy with arbekacin (ABK), or vancomycin (VCM) plus beta-lactam antibiotic is recommended especially for the treatment of respiratory tract infections.

Anti-Bacterial Agents↗
PubMed1992

[Effect of enkephalinase inhibitor on endothelin-1 induced bronchoconstriction in guinea pigs].

Endothelin-1 (ET-1) is one of the most potent bronchoconstrictors in the guinea pig. The mechanism of its metabolism is still unclear. Phosphoramidon is known to be an enkephalinase inhibitor. We studied the effect of phosphoramidon on bronchoconstriction induced by ET-1. In the first in vitro study, a tracheal preparation was mounted in oxygenated Krebs-Ringer solution. The response was monitored by isometric transducer. Dose-response curves to ET-1 with or without phosphoramidon were obtained. Phosphoramidon potentiated ET-1 induced bronchoconstriction significantly. Next, the specific airway conductance (sGaw) was measured in conscious guinea pigs exposed to an aerosol of phosphoramidon or saline, followed by ET-1 aerosol inhalation. The ET-1 dose was increased by successively doubling the concentration. sGaw, after inhalation of phosphoramidon, was significantly reduced when exposed to ET-1. Phosphoramidon also potentiated ET-1 induced bronchoconstriction in vivo. Next, lung parenchymal tissues were prepared and placed in oxygenated Krebs-Ringer solution with or without phosphoramidon. ET-1 was added and incubated, and samples were injected into a high performance liquid chromatography column. Phosphoramidon inhibited an analysis of ET-1. These data suggest that enkephalinase plays a role in the break down of ET-1 in the airway of the guinea pig. Under the condition of decreased enkephalinase, ET-1 would potentiate bronchoconstriction.

Animals↗
PubMed1992

[Diffuse large cell lymphoma with spontaneous regression in the lung and lymph nodes. Case report].

An 84-year-old woman was admitted to our hospital because of swelling of the cervical lymph nodes and multiple tumorous lesions observed on radiographic studies. Transcutaneous lung biopsy was performed, but necrosis of the tissue was too marked to make a diagnosis. The diagnosis of diffuse large-cell lymphoma was made based on a biopsy of the pretracheal lymph node. During the first two months after admission, the left cervical lymph nodes and most of the pulmonary lesions regressed not withstanding of special treatment for lymphoma. The patient eventually died of generalized peritonitis. At autopsy, metastasis of systemic organs by malignant lymphoma was observed. Most of the lung regions were cicatrized, but clusters of atypical lymphocytes were observed in the necrotic tissue. The tumor in the mucosa of the small intestine showed necrosis, which accounted for the intestinal perforation. The total clinical course after admission was about six months. Spontaneous regression of diffuse large cell lymphoma is rare, and this is the second reported case in Japan.

Aged↗
PubMed1992

Multiple organ failure in patients with fulminant hepatitis and in post-operative patients with liver cirrhosis.

Multiple organ failure (MOF) appeared during the course of nine cases with fulminant hepatitis, and it was compared with that of seven cirrhotic patients with post-operative hepatic failure. The number of organs failed was 4.9 and 3.6 on average in fulminant hepatitis and post-operative cirrhosis, respectively. All the patients died in less than nine days following the occurrence of MOF. Gastrointestinal bleeding was more frequently observed in fulminant hepatitis cases than in cirrhotic patients. In post-operative cirrhotics, hepatic failure occurred later and the elevation of serum total bilirubin was mild and slow. Renal failure and/or gastrointestinal bleeding was observed prior to death in fulminant hepatitis cases, and cardiac failure and hepatic failure in post-operative cirrhotics. These organ failures resulted in death, although extensive and multimodal treatments were carried out in both groups of patients.

Adult↗
PubMed1992

[Total aortic arch graft replacement using a prosthetic graft with three branches for acute type A aortic dissection].

Between March 1991 and August 1991, six consecutive patients underwent the replacement of the both ascending aorta and total aortic arch using a prosthetic graft with three branches for acute type A aortic dissection involving the aortic arch. Preoperative complications included cardiac tamponade in 5 cases, aortic regurgitation in 2, and shock state in 3. All operations were performed with the aid of extracorporeal circulation, selective cerebral perfusion, and open aortic anastomosis within 3 days after the onset. One patient died of rupture of the aortic anastomosis secondary to mediastinitis two weeks after the operation. All patients gained their own consciousness after the operation without any serious cerebral complications. The present data suggest that acute type A aortic dissection involving the aortic arch could be treated by replacing both the ascending aorta and aortic arch using a prosthetic graft with three branches with an aid of the extracorporeal circulation, selective cerebral perfusion and open distal anastomosis.

Acute Disease↗
PubMed1992

[Clinical and pharmacokinetic evaluations of meropenem in children].

Twenty-five children were treated with meropenem (MEPM, SM-7338) and the clinical efficacy and side effects were evaluated. Ages of the patients ranged from 9 months to 11 years. Dose levels of MEPM ranged from 50.4 to 108 mg/kg/day for 4 to 8 days. The 25 patients included 11 pneumonia cases, 4 bronchitis, 6 tonsillitis, 3 urinary tract infections and 1 gingivitis, and they were evaluated for the clinical efficacy of MEPM. Results were excellent in 13 and good in 12 patients. No side effects nor abnormal clinical laboratory test results were observed. The pharmacokinetics of MEPM was studied in 7 patients with ages ranging from 9 to 15 years. The mean plasma peak concentration of MEPM in 5 patients was 36.7 micrograms/ml after dosing 10 mg/kg, and that of 2 patients was 70.0 micrograms/ml after administering 20 mg/kg. These data showed that plasma concentrations of drug depended on dose levels. Average half-life values for the 2 groups (10 and 20 mg/kg) were 0.83 and 0.85 hour, respectively. Urinary recovery rates for the 2 groups (10 and 20 mg/kg) were 64.3% and 81.3%, respectively, in the first 5 hours after administration.

Absorption↗
PubMed1992

[Experience with re-cardiopulmonary bypass graft].

We report 14 consecutive patients who have undergone ReCABG during the last 7 years (1984-1990). There were 11 males and 3 females with a mean age of 56.8 years. All bypass conduits used were saphenous vein grafts. Angiographic indications for ReCABG included primary bypass graft failure, progressive coronary arteriosclerosis, and both of them. Successful ReCABG is mainly dependent on careful attention to special surgical technical considerations such as heart exposure especially in the existence of functioning bypass graft, cardiopulmonary bypass technique and myocardial protection and choice of available bypass conduits. We used arterial grafts in 6 cases (ITA in 4 and GEA in 2 cases). There was only one hospital mortality in our series. Symptomatic relief of angina pectoris was obtained in all surviving patients.

Aged↗
PubMed1992

Cerebral edema during hepatic encephalopathy in fulminant hepatic failure.

Thirteen out of 18 patients with fulminant hepatitis developed cerebral edema macroscopically confirmed at autopsy. Cerebral bleeding and herniation were also observed in 38 and 8% of edema cases, respectively. No significant difference was found in the clinical backgrounds (age, sex, laboratory data) of patients with and without cerebral edema. Respiratory distress (100% of edema cases, p less than 0.05), abnormal pupils (89%, p less than 0.10), convulsions (61%) and tachycardia unrelated to fever (60%) were more frequently observed in cerebral edema cases than in those without edema. The frequency of convulsions increased as hepatic encephalopathy progressed, and the frequency of respiratory distress and abnormal pupils in edema cases was significantly higher at the coma grade V of hepatic encephalopathy. Tachycardia was detected early, even at the mild grades of hepatic encephalopathy. These results suggest that symptoms due to cerebral edema such as convulsions, abnormal pupils and respiratory distress should be distinguished from those due to hepatic encephalopathy in fulminant hepatitis patients.

Adult↗
PubMed1992

Gastric carcinoma invading muscularis propria and macroscopic appearance.

From 1965 to 1983, 1362 patients with primary gastric cancer and no other evidence of a malignancy underwent gastric resection in the Second Department of Surgery, Kyushu University. Of these, 117 patients (8.6%) with gastric cancer invading the muscularis propria (pm) were studied clinicopathologically with special reference to the macroscopic appearance: Borrmann type cancer or advanced gastric cancer simulating early gastric cancer (AGC simulating EGC). The Borrmann type cancer comprised 62.4% (73/117) of cases and the AGC simulating EGC comprised 37.6% (44/117). The survival rate for patients with the Borrmann type cancer was lower than in cases of AGC simulating EGC (P less than 0.01). The 10-year survival rate was 82.6% for patients with AGC simulating EGC and 60.5% for those with Borrmann type cancer. A multivariate analysis showed that operative curability and lymph node metastasis are significant prognostic factors and these events differed between the Borrmann type cancer and AGC simulating EGC and the survival rate for patients with the Borrmann type cancer was less favorable. Our findings show that the lymph node dissection is important for the operative curability of pm gastric cancer with the Borrmann type. Postoperative chemotherapy is required in cases of a non-curative resection.

Adult↗
PubMed1992

[Surgical treatment of Marfan's syndrome with annulo aortic ectasia and mitral regurgitation].

This report is concerned with results of surgical treatment for Marfan's syndrome combined with annulo-aortic ectasia (AAE) and mitral regurgitation (MR). Of the 23 patients with Marfan's syndrome who received Bentall's procedure during 14 year period, seven (30%) of these patients had both AAE and MR. The MR grade of seven patients by cardiac Doppler or left ventriculographic studies were grade 1 in 2, 2 in 1, 3 in 1, and 4 in 3. Atrial fibrillation was present in 4 patients. New York Heart Association Functional Class on admission in these 7 patients were II in 1, III in 4, and IV in 2. The mitral valve was replaced with mechanical valve in 4 patients by left atrial approach whose MR grade were over 3. In the 4 patients the mitral annuli were extremely dilated, both valve leaflets were massively redundant, and all chordae were elongated and turned chordae and vegetation were detected due to infective endocarditis. Only Bentall's procedure was performed in 3 patients whose MR were minimal. There were no early death, but two late deaths. One of them died of cardiac failure 2.3 years after Bentall's procedure because grade 2 MR was increased. Another one died from ventricular arrhythmia 1.6 years after MVR and Bentall's procedure. The remaining 5 patients are doing well for 3 months to 11.5 years after operation. For Marfan's syndrome combined with AAE and MR, early operation is recommended before left ventricular impairment. Mitral valve repair was not performed, both to save time and because anticoagulant therapy was need for aortic valve replacement. Concomitant MVR was to be done for moderate to severe MR.

Adult↗
PubMed1992

[Changes of immunity in the patients undergoing surgery for esophageal cancer].

The kinetics of subpopulations and functional subsets of circulating immune cell, humoral antibody and complement were examined in the 18 patients undergoing surgery with thoracotomy and laparotomy for esophageal cancer. The following results were obtained. 1. Preoperative IgG-Fc-receptor (+) T cell (Tr cell) level was higher than normal level. 2. From 1st post operative day (1POD) to 14POD, WBC counts have increased, lymphocyte counts (especially T cell counts) have decreased significantly as compared with preoperative level. 3. In T cell subsets, counts of Tr cell have decreased significantly from 1POD to 3POD as compared with preoperative counts. 4. Counts of OKT8 positive cells (suppressor or cytotoxic T cell) and OKT4 positive cells (helper or inducer T cell) have decreased significantly from 1POD to 3POD as compared with preoperative count. OKT4/OKT8 ratio increased at 3POD (2.31 +/- 1.33). 5. In B cell subsets divided into using the type of cell surface immune antibody (sIgG, sIgA, sIgD), all subsets have decreased significantly as compared with preoperative counts. 6. Immune globulin (IgG, IgA, IgM, IgD) have decreased significantly from 1POD to 7POD, but at 14POD they increased significantly as compared with preoperative levels. 7. Complements (C3, C4) have decreased significantly from 1POD to 7POD. 8. The count of sIgG positive B cell had significant, negative correlation with carcinogenic factor and positive correlation with preoperative serum total protein. The other immune factors had no correlation with the factors before and during operation. These results suggest that cellular immunity of patients undergoing surgery with thoracotomy and laparotomy for esophageal cancer lose its autoregulation function especially in T cell, it does not recover until 14POD.

Aged↗
PubMed1992

[A case of primary antiphospholipid syndrome with fever, pulmonary thromboembolism and endocardial lesion].

A previously healthy 16-year-old girl complaining of fever, hemosputum, chest pain and dyspnea was hospitalized. On admission, physical examination revealed mental confusion, holosystolic heart murmur, and swelling of the left foot. Laboratory investigations showed anemia, leukocytosis, thrombocytopenia, activation of inflammatory reactions, prolongation of PT and APTT, and hypoxia. Antinuclear antibody test was negative. There were no other findings suggestive of collagen diseases such as SLE. Chest X-ray showed consolidation in the left lower lung field and pleural effusion. Echocardiography disclosed a mass lesion in the left atrium in contact with the mitral valve, and mitral regurgitation. No findings indicative of an infectious etiology were present. The patient rapidly improved with high dose corticosteroid and anticoagulant therapy. A venogram of the lower extremity disclosed deep venous thrombosis. A lung ventilation-perfusion scan revealed multiple pulmonary thromboemboli. Elevation of anticardiolipin antibody was noted. Based on these findings, the diagnosis of primary antiphospholipid syndrome was made. Further administration of steroid and anticoagulant resulted in decrease of the titer of anticardiolipin antibody. This is the second report of primary antiphospholipid syndrome in Japan. The clinical significance of this disease is also discussed.

Adolescent↗
PubMed1991

Diversity of a ribonucleoprotein family in tobacco chloroplasts: two new chloroplast ribonucleoproteins and a phylogenetic tree of ten chloroplast RNA-binding domains.

Two new ribonucleoproteins (RNPs) have been identified from a tobacco chloroplast lysate. These two proteins (cp29A and cp29B) are nuclear-encoded and have a less affinity to single-stranded DNA as compared with three other chloroplast RNPs (cp28, cp31 and cp33) previously isolated. DNA sequencing revealed that both contain two consensus sequence-type homologous RNA-binding domains (CS-RBDs) and a very acidic amino-terminal domain but shorter than that of cp28, cp31 and cp33. Comparison of cp29A and cp29B showed a 19 amino acid insertion in the region separating the two CS-RBDs in cp29B. This insertion results in three tandem repeats of a glycine-rich sequence of 10 amino acids, which is a novel feature in RNPs. The two proteins are encoded by different single nuclear genes and no alternatively spliced transcripts could be identified. We constructed a phylogenetic tree for the ten chloroplast CS-RBDs. These results suggest that there is a sizable RNP family in chloroplasts and the diversity was mainly generated through a series of gene duplications rather than through alternative pre-mRNA splicing. The gene for cp29B contains three introns. The first and second introns interrupt the first CS-RBD and the third intron does the second CS-RBD. The position of the first intron site is the same as that in the human hnRNP A1 protein gene.

Amino Acid Sequence↗