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Biomedical subjects

A Watanabe

Publications and source records attributed to A Watanabe.

At least 901 records · Page 50Linked to original sources

Plasma amino acid imbalance in alcoholic liver cirrhosis.

Plasma amino acid concentrations and plasma glucagon and serum insulin levels were studied in male patients with compensated alcoholic and nonalcoholic liver cirrhosis. Age, nutritional status, and liver function tests were similar in both groups; none of the patients presented hepatic encephalopathy. Plasma valine and leucine concentrations were lower, and tyrosine, higher in alcoholic than nonalcoholic liver cirrhosis. As a result, the molar ratios of branched-chain amino acids (BCAA) to aromatic amino acids (AAA) were reduced markedly in this group. Although correlation coefficients comparing BCAA/AAA ratios and KICG in alcoholic and nonalcoholic liver cirrhosis were similar, a steeper regression line was observed in alcoholics. Plasma glucagon and proline levels were significantly higher in alcoholic than nonalcoholic liver cirrhosis, the former correlated with AAA concentrations only in alcoholic liver cirrhosis, but not with BCAA levels. These results indicated that alcoholic liver cirrhosis presented a more deranged plasma amino acid pattern than nonalcoholic, and the amino acid imbalances, except for depressed BCAA and elevated proline, were derived, in part, from the hyperglucagonemia.

Adult↗

Glutamic acid and glutamine levels in serum and cerebrospinal fluid in hepatic encephalopathy.

Significant elevation of glutamic acid and glutamine concentrations in CSF was observed in hepatic encephalopathic patients with fulminant hepatitis and liver cirrhosis. However, the ratios of CSF glutamic acid to CSF glutamine levels and of CSF to serum glutamic acid and glutamine levels were significantly higher only in cirrhotic patients with hepatic encephalopathy. CSF glutamine levels were positively correlated with blood ammonia and CSF tyrosine levels in cirrhotic patients. The results indicate that CSF glutamic acid and glutamine levels are important tools in diagnosing hepatic encephalopathy in severe liver disease.

Adult↗

Effects of branched-chain alpha-keto acids on plasma amino acid concentrations in carbon tetrachloride-intoxicated rats.

Plasma branched-chain amino acid levels during continuous intravenous infusion of sodium salts of branched-chain alpha-keto acid were much higher in CCl4-intoxicated rats than in control rats. However, increases after intragastric administration were diminished in both groups. Increased plasma alloisoleucine levels following administration of R,S-alpha-keto-beta-methylvaleric acid were reduced greatly by using only S-alpha-keto-beta-methylvaleric acid.

Amino Acids↗

Hepatocellular carcinoma of small size.

Clinicopathological features of hepatocellular carcinoma (HCC) of small size, not larger than 5.0 cm in diameter, were studied in 11 patients with underlying cirrhosis. The presence of tumor was detected and confirmed by computed tomography (CT) and ultrasonography (US) during periodic imaging re-examinations of cirrhotic patients. The HCCs grew slowly up to a certain stage and formed satellite tumors that could not be visualized on CT image. Therefore, infusion hepatic angiography and/or transcatheter arterial embolization (TAE) are essential before undertaking a major operation.

Aged↗

Nonicteric liver damage with a gamma-glutamyl transpeptidase level of 5,609 units/l in a renal-transplant recipient receiving azathioprine.

A 26-year-old male with renal allograft, who received immunosuppressive treatment with azathioprine, presented marked elevations of serum biliary tract enzymes, such as gamma-glutamyl transpeptidase (5,609 units/l) and alkaline phosphatase (60.5 Bessey-Lowry units), 14 months after transplantation. Two months later the patient became icteric; he died of respiratory failure 19 months after the renal allograft. Postmortem examination revealed intrahepatic cholestasis with minimal inflammatory cell infiltration, indicating drug hepatotoxicity.

Adult↗

Two cases of constitutional unconjugated hyperbilirubinemia with marked retention of indocyanine green.

Two cases of chronic unconjugated hyperbilirubinemia and marked retention of indocyanine green (ICG) are described. Since bilirubin uridine diphosphate (UDP)-glucuronyl transferase activities were depressed in their liver, the patients seemed to have bilirubin metabolism similar to that in Gilbert's syndrome. However, the ICG fractional disappearance rates of the cases were rather low (0.018 and 0.019) compared to the rates reported for Gilbert's syndrome. These results suggest that the patients had a new metabolic disorder which results in constitutional unconjugated hyperbilirubinemia and ICG intolerance.

Adult↗

Prevention of methionine and ammonia-induced coma by intravenous infusion of a branched chain amino acid solution to rats with liver injury.

The prevention of hepatic encephalopathy by the intravenous infusion of a branched chain amino acid (BCAA)-enriched solution was investigated in methionine and ammonium acetate-treated rats whose liver was already injured with carbon tetrachloride. A BCAA-enriched solution protected the rats from entering a coma. The brain BCAA contents became higher, and the brain methionine and tyrosine levels and the ratio of glutamine to glutamic acid in the brain diminished after administering the BCAA-enriched solution.

Acetates↗

Potentiation of carbon tetrachloride hepatotoxicity by beta-phenethyl alcohol.

Carbon tetrachloride (CCl4)-induced hepatotoxicity was potentiated by pretreatment with beta-phenethyl alcohol, abundantly present in sake. The injury was determined by serum GPT levels and histological examination. Similar results were observed in ethanol- and phenobarbital-pretreated rats. Acetaminophen-induced hepatotoxicity was not accentuated by beta-phenethyl alcohol or ethanol pretreatment. The activities of liver microsomal enzymes, such as cytochrome P-450, cytochrome b5 reductase, aniline hydroxylase and aminopyrine demethylase, were not altered in beta-phenethyl alcohol-pretreated rats. Thus, CCl4-induced hepatotoxicity potentiation by beta-phenethyl alcohol administration is postulated to be due to a mechanism other than increased free radical generation.

Acetaminophen↗

An adult case of chronic myelogenous leukemia with myeloblastic involvement of the central nervous system.

A 31-year-old female with chronic myelogenous leukemia, who developed myeloblastic involvement of the central nervous system during acute myeloblastic transformation of the disease, was treated with methotrexate intrathecally. The therapy produced prompt clinical response and complete reversal of abnormal cerebrospinal fluid findings. However, the patient expired 10 months following the acute blastic crisis.

Adult↗

Clinical significance of eosinophilia in the diagnosis of halothane-induced liver injury.

Three patients with severe halothane-induced liver injury are described. All patients received halothane anesthesia twice within a short period. High fever and jaundice were noticed soon after the second operation. The prothrombin time was less than 40%, and eosinophilia was greater than 7% prior to these symptoms. Other causes of liver injury were excluded. Diagnostic criteria for halothane-induced liver injury are proposed.

Adult↗

A case of cornstarch granuloma.

A 57-year-old female was diagnosed as having asymptomatic cornstarch granuloma. The disseminated small nodules over the peritoneum were incidentally discovered at operation for cholelithiasis, when she was misdiagnosed as carcinomatosis peritonei. Histological observations revealed a characteristic finding of tuberculoid granuloma with caseous necrosis, a rather rare histological type of cornstarch granuloma. Polarized light microscopic examination of biopsy specimens is particularly important for the diagnosis. We emphasize that cornstarch granuloma should once be considered when tuberculoid or unknown abdominal granuloma are observed in patients with history of abdominal surgery.

Female↗

A case of chronic neutrophilic leukemia with paraproteinemia (IgG Type lambda and IgA Type K).

An unusual case of chronic neutrophilic leukemia associated with paraproteinemia (IgG Type lambda and IgA Type K) was followed for 3 years. Clinical and hematological findings obtained during the entire course fulfil the previously reported criteria for the diagnosis of chronic neutrophilic leukemia. A marked infiltration of mature neutrophils in the spleen and liver was confirmed by postmortem examination.

Aged↗

[Clinical experience on sulbactam/cefoperazone in the pediatric field].

Approximately 20 mg/kg/day of sulbactam/cefoperazone (SBT/CPZ) was given by one shot intravenous injection to 16 pediatric inpatients with respiratory tract infections (13 cases), urinary tract infection (1 case), skin infection (1 case) or gastrointestinal tract infection (1 case). An excellent efficacy in 6 cases and a good efficacy in 10 cases were observed. Causative organisms were not identified in the respiratory tract infections, even though the efficacy was excellent or good. Side effects were not noticed in particular and SBT/CPZ was judged as safe enough agent. Concentrations of SBT/CPZ in the spinal fluid were determined in 3 patients. Their low concentrations suggested the poor transfer into the spinal fluid. Finally, SBT/CPZ is a very useful agent since it is effective also against resistant organisms which produce penicillinase-type beta-lactamases.

Adolescent↗

[Clinical evaluation of ceftriaxone in pediatric infections].

Ceftriaxone (Ro 13-9904, CTRX) was evaluated in 20 children with a suspicion of bacterial infections, 18 were shown to be effective (efficacy rate, 90%). The diagnosis included upper respiratory tract infection (3), bronchitis (3), pneumonia (8) and urinary tract infection (6). The etiologic pathogens isolated were S. pneumoniae (1), and enteropathogenic E. coli (6). These strains were eradicated after treatment. No severe adverse reaction was encountered with the CTRX therapy. The data suggest that CTRX is an effective and safe parenteral antibiotic in the treatment of susceptible pediatric bacterial infections.

Cefotaxime↗

[Bacteriological, pharmacokinetic and clinical studies on sulbactam/cefoperazone in the pediatric field].

Bacteriological and clinical effect of a newly developed SBT/CPZ in the treatment for pediatric patients was assessed by a study group consisting of 15 institutions. The results were as follows. Antibacterial effect Susceptibility studies were performed with 93 clinical isolates. The MIC of SBT/CPZ was one-tube inferior or almost similar to that of CPZ in susceptible organisms. In CPZ-resistant organisms at the inoculum of 10(8) cells/ml, however, SBT/CPZ was much superior to CPZ on the basis of the MIC. When the MIC of SBT/CPZ was compared to that of CPZ in 27 strains which have high beta-lactamase-producing activity, it was found that many of CPZ-resistant organisms were susceptible to SBT/CPZ. Serum concentration and urinary excretion The serum concentrations of SBT and CPZ were 33.2 micrograms/ml, respectively at 15 minutes after 20 mg/kg SBT/CPZ was administered by intravenous bolus injection, and those of SBT and CPZ, 51.0 micrograms/ml and 108.3 micrograms/ml, respectively following 40 mg/kg SBT/CPZ therapy. The serum concentrations of CPZ were 2.1-2.4 times as high as those of SBT. The concentrations were dose-related. The half-lives of SBT and CPZ following 20 mg/kg SBT/CPZ administration were 0.94 hour and 1.50 hours, respectively, and those following 40 mg/kg SBT/CPZ were 0.95 hour and 1.53 hours, respectively. There was no significant difference between 20 mg/kg and 40 mg/kg administrations. When compared between SBT and CPZ, CPZ had slightly longer half-lives. At the termination of 1 hour drip infusion of 20 mg/kg SBT/CPZ, the serum concentrations of SBT and CPZ were 16.7 micrograms/ml and 40.1 micrograms/ml, respectively. In the case of 40 mg/kg, the levels of SBT and CPZ were 38.6 micrograms/ml and 94.9 micrograms/ml, respectively. The concentrations were found to be dose-related as were following intravenous bolus injections. The SBT half-lives obtained after 20 mg/kg and 40 mg/kg SBT/CPZ administrations were 1.39 hours and 0.89 hour, respectively; those of CPZ, 2.00 hours and 1.44 hours, respectively. The highest urinary concentration occurred 0-2 hours after intravenous bolus injections of 20 mg/kg or 40 mg/kg SBT/CPZ. Urinary excretion of SBT over 6 hours was 60.0% and 67.7%, and that of CPZ, 21.2% and 25.0%, indicating higher urinary excretion for SBT. When 20 mg/kg SBT/CPZ or 40 mg/kg was administered over 1 hour by drip infusion, urinary excretion became the highest at 1-3 hours after administration. Urinary excretion of SBT over 7 hours following 20 mg/kg and 40 mg/kg SBT/CPZ was 68.8% and 80.3%, respectively, and that of CPZ, 24.4% and 27.3%. The results were similar to those observed following intravenous bolus injections.

Adolescent↗

[Clinical evaluation of ceftazidime in the field of pediatrics].

Clinical responses of ceftazidime (CAZ) in 13 cases of respiratory tract infections were excellent in 7 and good in 6, and those in 4 of urinary tract infections were excellent in 1 and good in 3. Clinical responses of CAZ in 3 cases of acute gastroenteritis were good in 1 and fair in 2. CAZ was considered to be effective both in respiratory and urinary tract infections; however, CAZ did not seem to be very effective clinically in gastrointestinal infections. As to side effects, slight elevation of GOT was observed in 3 cases and skin rash in 1 case, but all these abnormalities were mild and transient.

Age Factors↗