Biomedical subjects

H Baba

Publications and source records attributed to H Baba.

At least 271 records · Page 15Linked to original sources

PubMed1994

Proliferative activity as a prognostic factor in Borrmann type 4 gastric carcinoma.

Proliferative activities in 181 primary Borrmann type 4 gastric carcinomas were investigated using percentage labelling of proliferating cell nuclear antigen (PCNA) and an argyrophilic nucleolar organiser region (AgNOR) count. Tumours with a high proliferative activity often metastasised to lymph nodes (P < 0.01), and these patients had a lower survival rate (P < 0.05). A significant correlation was recognised between the PCNA labelling percentage and AgNOR count (r = 0.452, P < 0.001). Cox's regression analysis showed that PCNA labelling percentage is an independent prognostic factor. These results indicate that estimating proliferative activity may be useful in predicting lymph node metastasis and patients' prognosis in cases of Borrmann type 4 gastric carcinoma.

Adenocarcinoma↗

PubMed1994

Combined evaluation of preoperative serum sialyl-Tn antigen and carcinoembryonic antigen levels is prognostic for gastric cancer patients.

We have found that elevation of preoperative serum sialyl-Tn antigen (STN) levels is associated with a poor prognosis for gastric cancer patients, and these high levels remain in the advanced stage of the disease. We have now examined findings with the combined assay of STN and carcinoembryonic antigen (CEA) levels with regard to prediction of the prognosis of gastric cancer patients. Serum CEA levels and STN levels were determined preoperatively in 349 Japanese patients with gastric cancer. The patients were divided into four groups: (A) the CEA (-) STN (-) group (CEA < or = 5 ng ml-1, STN < or = 45 U ml-1, n = 286); (B) the CEA (-) STN (+) group (CEA < or = 5 ng ml-1, STN > 45 U ml-1, n = 31); (C) the CEA (+) STN (-) group (CEA > 5 ng ml-1, STN < or = 45 U ml-1, n = 17); and (D) the CEA (+) STN (+) group (CEA > 5 ng ml-1, STN > 45 U ml-1, n = 15). Clinicopathological features and the prognosis of these groups were examined. The distribution of two markers showed no significant correlation. The patients in the CEA (+) STN (+) group (group D) had more advanced disease than the patients in CEA (-) STN (-) group (group A); tumour size was larger, serosal invasion was prominent, lymphatic and vascular involvement was frequent and the tumour was more infiltrative. Lymph node metastasis and hepatic metastasis were more common. Total gastrectomy was usually performed, and the non-curative rate was higher. The 5-year survival of patients in the CEA (+) STN (+) (group D) was 14.5 +/- 9.5%, that is lower than that of patients in any other group [CEA (+) STN (-) (group C) 44.1 +/- 12.7% (P < 0.05); CEA (-) STN (+) (group B) 60.1 +/- 9.5% (P > 0.05); CEA (-) STN (-) (group A) 77.6 +/- 9.5% (P < 0.05)]. This combined assay of these markers will aid in estimating the prognosis and selecting appropriate drugs and care for gastric cancer patients.

Aged↗

PubMed1994

Spinal cord potential recordings from the extradural space during scoliosis surgery.

For monitoring spinal cord functions during corrective surgery of scoliosis, we have recorded percutaneously from the posterior extradural space at the C5-7 levels the ascending conducted spinal cord potentials (ASCP) in response to extradural stimulation of the cauda equina in 134 patients. The ASCP consists of three spike-like components (C1, C2 and C3) followed by slow components. The extradurally recorded ASCP were not affected by anaesthetic agents. There were no significant differential effects of spinal distractions on each of the three spike potentials. There were no post-operative neurological abnormalities in patients whose ASCP showed no changes, amplitude increases, amplitude decreases of less than 50% or latency increases (> 0.2 ms) during spinal manipulations (no false negatives, but some false positives). Five patients who suffered postoperative neurological damage exhibited more than 50% changes in amplitude of the ASCP during surgery. All these neurological sequelae occurred in the first 80 patients. In the last 54 patients, in whom the distraction forces on the spine were controlled rapidly by observation of the amplitude changes in ASCP, there were no postoperative neurological abnormalities, except for one patient in whom an accidental spinal cord injury was produced by a hook. The results suggest that the distraction force on the spine must be reduced immediately when the amplitudes of the ASCP decrease by more than 50% of control values with or without latency increases.

Adolescent↗

PubMed1994

Erb's point stimulation produces slow positive potentials in the human lumbar spinal cord.

Evoked spinal cord potentials (SCPs) were recorded from the posterior epidural space (PES) at the cervical and lumbrosacral enlargements in response to electrical stimulation of the brachial plexus at Erb's point in 17 chronic pain patients. Erb's point stimulation produced slow positive potentials (heterosegmental slow positive potentials, HSPs) in the PES at the lumbrosacral enlargement in all 13 subjects without spinal cord lesions but not in 4 subjects with spinal cord lesions. The HSP1 with a central peak latency of 21 +/- 2 ms (mean +/- SE) was recorded at the stimulus intensity up to two to three times the threshold strength (T) of the initially positive spike (P1) of the segmental SCP, which was simultaneously recorded from the PES at the cervical enlargement. At the stimulus intensity of more than 3T, another slow positive potential (HSP2) with central peak latency of 71 +/- 6 ms was recorded. These slow positive potentials (HSP1 and HSP2) might be produced by a feedback loop via supraspinal structures, presumably primary afferent depolarizations, in comparison to the HSPs of our previous studies in the rat. Slow negative potentials were sometimes noted before (5 of 13) and/or after (2 of 13) the HSP1. These slow negative potentials probably reflect the activities of dorsal horn neurons producing the HSP1 and HSP2, respectively, also elicited by a feedback loop via supraspinal structures.

Adolescent↗

PubMed1994

Coaggregation between Porphyromonas gingivalis and mutans streptococci.

Coaggregation occurred between Porphyromonas gingivalis and mutans streptococci. The coaggregation was completely inhibited by L-arginine, N alpha-p-tosyl-L-lysine chloromethyl ketone (TLCK), and a trypsin inhibitor, and weakly inhibited by L-lysine, N-ethylmaleimide, lysozyme, and human whole saliva. The results of heat and proteinase K treatment suggested that a heat-labile proteinaceous substance of P. gingivalis and a heat-stable substance of mutans streptococci may play a role in the coaggregation. Mutans streptococci also aggregated in the presence of the heat-labile factor in the supernatant of P. gingivalis. The aggregation was also inhibited by L-arginine, TLCK, and a trypsin inhibitor.

Bacterial Adhesion↗

PubMed1994

Nonpeptide angiotensin II receptor antagonists. I. Synthesis and biological activity of pyridine derivatives.

Substituted pyridines were synthesized as potential angiotensin II (AII) receptor antagonists. Substitution at the position 2 in the pyridine resulted in potent activity, and the optimal alkyl length was four carbons. The potency further increased with the introduction of a hydroxymethyl group at the position 4. One of the compounds, 2-butyl-6-chloro-4-hydroxymethyl-5-methyl-3-[[2'-(1H-tetrazol-5-yl )biphenyl-4-yl]methyl]pyridine 9 h (KT3-579) is a competitive AII antagonist with a pA2 value of 9.31, and is about 10 times more potent than Du Pont 753. It was found to be an AT1 specific antagonist with an IC50 of 3.09 nM.

Angiotensin Receptor Antagonists↗

PubMed1994

[Intra-arterial combination chemotherapy using both regimen selected by chemosensitivity test and caffeine to increase effect for osteosarcoma in extremity].

We treated three patients with osteosarcoma in extremity with intra-arterial combination chemotherapy using a regimen selected by succinate dehydrogenase inhibition chemosensitivity test, and used caffeine to enhance its effect. In two patients with osteosarcoma in distal diametaphysis of the radius and extraskeletal osteosarcoma in sole of the foot, the effect of intra-arterial combination chemotherapy was increased and followed by the functional limb salvage procedure. But in one patient with osteosarcoma in the proximal tibia, the effect of pre-operative intra-arterial combination chemotherapy could not be increased, so amputation was required. He was changed to a post-operative intra-venous combination chemotherapy regimen selected by chemosensitivity test of the surgical material. All patients have been continuously disease-free at five to twelve months after surgery.

Adolescent↗

PubMed1994

Lymph node metastasis and macroscopic features in early gastric cancer.

The relationship between macroscopic features and the frequency and extent of lymph node metastasis was examined retrospectively in 421 patients with early gastric cancer. Nodal involvement was evident in 48 patients (11.4%): 7 out of 204 (3.4%) with mucosal cancer and 41 out of 217 (19.3%) with submucosal lesions. The incidence of metastasis to perigastric nodes and extraperigastric nodes was 2.9% and 0.5% for mucosal cancer, and 13.8% and 5.1% for submucosal cancer, respectively. There was no metastasis in lesions less than 1 cm in diameter, but the incidence of positive nodes increased with the size of the primary lesion. There was a low incidence of lymph node metastasis associated with lesions confined to the mucosa and less than 3 cm in size, elevated types of I and IIa less than 2 cm, and the flat type of IIb, while types consisting of a depressed portion such as IIc, III, IIc + III, and IIa + IIc often had not only perigastric but also extraperigastric nodal involvement, even when the lesion was small. As early gastric cancer can be cured by surgery, this modality is the treatment of choice. Endoscopic therapy in cases with a low involvement of lymph node metastasis can be considered when the patient is in a poor clinical state of health.

Adult↗

PubMed1994

[Evaluation of the streptomycin twice weekly with INH and RFP for initial therapy of pulmonary tuberculosis].

For the purpose to compare the effectiveness of SM and EB as a third drug in the standard regimens and to know whether the addition of SM twice weekly to INH and RFP could be acceptable for the treatment of pulmonary tuberculosis, the efficacy, adverse effects and results of long-term follow-up of the groups consisting of 105 patients treated with SM twice weekly for 6 months in addition to INH and RFP for 9 months (S2 group) and 107 patients treated with EB for 6 months in addition to INH and RFP for 9 months (E group) were observed. The speed of negative conversion of sputum and that of X-ray findings improvement were slightly faster in S2 group than E group but the difference was statistically not significant. The incidence of adverse effects such as elevation of serum transaminase values, gastrointestinal troubles, drug allergy and others was not similar in two groups. The relapse was observed in 2 cases of S2 group and 5 cases of E group. We concluded that SM twice weekly to INH and RFP is similarly effective as EB in combination with INH and RFP, and the this regimen could be used as standard regimen for pulmonary tuberculosis.

Adult↗

PubMed1994

[Studies on the problems of resistance to antituberculous drugs. II--1. Clinically applicable criteria of drug-resistance to rifampicin].

Preliminary studies showed that some strains of tubercle bacilli were inhibited even by 2 micrograms/ml of rifampicin (RFP), but 10 micrograms/ml or higher concentrations were needed for the inhibition of all strains. Of 5,100 patients with pulmonary tuberculosis who were admitted to our hospital during 12 years since January 1970 through 1981, 1,344 patients had no previous antituberculous drug therapy. All of the strains of Mycobacterium tuberculosis isolated from such 1,344 patients showed no or less than 10% growth of control on 10 micrograms-RFP medium by indirect susceptibility tests. But, I defined the clinically applicable criteria of resistance to RFP as "more than 1% growth of control on 10 micrograms-RFP medium" because of following reasons: 1) the growth more than 1% and less than 10% of control on 10 micrograms-RFP medium could be reasonably explained as the results of some technical failures, 2) the results of follow-up observations of respective cases, 3) our previous studies on the distribution of RFP-susceptibility of natural resistant strains. Among total 5,100 cases, 605 cases had been treated with antituberculous drugs previously but failed to achieve negative conversion of the bacilli, and restarted the treatment with regimen including RFP (retreatment group), and the remains had no previous treatment (initial treatment group). The negative conversion rates within three months of treatment were almost same (more than 95%) in both groups, but the rates of RFP-resistance were 5.6% for the initial treatment group and 92.8% for the retreatment group. Among 605 retreated cases 129 were susceptible to RFP at the start of the treatment but became resistant to RFP, of which 11 were resistant to 10 micrograms/ml and 118 to 50 micrograms/ml RFP. Two of the 11 10 micrograms-resistant cases remained to be 10 micrograms-resistant until their death (8 and 15 months after the start of the therapy, respectively) though their critical proportions showed some fluctuations. Remaining 9 cases later became resistant to 50 micrograms/ml RFP. By the 50 micrograms-resistant cases with lower critical proportion, the increase of critical proportion was rarely observed and did not reach even 50%. "Fall-and-rise" phenomena were observed rather frequently during the course of treatment with regimens including RFP. The decrease of the number of bacilli in sputa, sometimes to culture-negativity, at the initial phase of the treatment may be an evidence of killing of susceptible bacilli. If bacilli reappeared or increased their number, it is a critical time to reassess the treatment schedule.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗

PubMed1994

[Studies on the problems of resistance to antituberculous drugs. II--2. Clinically significant critical concentration of streptomycin, isoniazid, kanamycin and ethambutol].

The proportion method demands an exact count of the colonies on the control and drug-containing media to calculate an exact percentage of resistant bacilli among bacilli-population. To realize this objective, the bacilli suspension must be fresh and homogeneous, susceptible and resistant bacilli must be equally distributed, each bacillus must be dispersed as a single cell when the bacilli suspension is diluted, colony count must be reduced at a rate parallel to the dilution. The critical concentration of each drug should essentially be determined in a clinical manner, however as the multi-drug combination therapy in the rule for the treatment of tuberculosis, it is very difficult to make an exact determination of the resistance to each of drugs. It may be better, as Canetti pointed out, to decide using the pure bacteriological method and later compare findings with clinical studies, making changes in the future if so required. We choose to follow their criteria for nearly all of the drugs making only a few exceptions. 1) SM: DH-SM is not available in Japan as Japanese government prohibits its production. Growth on the medium containing SM (only concentration of less than 4 micrograms/ml) was more abundant than on DH-SM media. Not knowing the fact that when an air-tight cap was used on the medium tube, the result of susceptible test shows 4-10 times higher resistance, we first used an air permeable cork cap. Futamura noticed the fact later and devised the M-type cap, which is air-tight originally, but allows air to flow into the tube automatically when needed. But such cap seemed not necessarily to be expected when employed routinely in the case of a SM concentration of 4 micrograms/ml. Next for the clinical study, considering the combined triple-drug treatment and relapse rate of positive bacilli after six months and one year, we adopted an 1% SM solution (10 micrograms/ml) and the 0.2 microgram/ml of INH as the clinically significant criteria. 2) RFP: Among previously untreated patients, 1,346 were tested using only the indirect method, revealing a critical concentration at 10 micrograms/ml. Their critical proportions were 1-9% in 14 patients (1.0%) which might be technical mistakes, because retested 1/3 cases of them were found 0% to 10 micrograms/ml of RFP and the remaining 2/3 also must be 0%. For the detailed explanation, please see the literature (5). There were also 3 patients who critical proportion were 50% or more.(ABSTRACT TRUNCATED AT 400 WORDS)

Antitubercular Agents↗

PubMed1994

[A case of multiple myeloma associated with a large subcutaneous mass in the frontal region].

A case of multiple myeloma having plasmacytoma in the frontal bone and clivus is reported. A 68-year-old female was referred to our hospital because of a subcutaneous mass in the frontal region. She was diagnosed as having multiple myeloma 7 years ago and had been treated with chemotherapy. On admission, severe anemia, hyperproteinemia and elevation of serum lambda type immunoglobulin G (IgG) were pointed out. Plain skull X-rays showed numerous punched out lesions with a large bone defect of the frontal bone. CT scan and MRI revealed a mass lesion in the clivus in addition to a large epidural tumor in the frontal region. The encapsulated frontal epidural tumor was totally resected and cranioplasty was performed with resin. Histological diagnosis was plasmacytoma of IgG lambda type. The postoperative course was uneventful, and chemotherapy was continued. There was no tumor recurrence in the frontal region and no neurological deterioration, but she died of DIC 15 months after the operation. Twenty seven cases in the literature of multiple myeloma forming cranial or intracranial plasmacytoma were briefly reviewed. Although the prognosis of such cases is poor, total resection of medullary plasmacytoma is warranted especially in multiple myeloma patients who don't have another extramedullary plasmacytoma or plasma cell leukemia.

Aged↗

PubMed1994

[Heterogeneity in gastric carcinoma with special reference to DNA content and mitotic activity: histopathologic differentiation].

DNA ploidy was microspectrophotometrically investigated in 46 patients with gastric carcinoma. Measurements of DNA content and mitotic index (MI) were examined in the mucosal, submucosal, muscularis propria, and serosal layers of tumors, respectively. The frequency of cells with values exceeding hexaploid chromosome (6c) and mitotic counting analysis revealed a significantly higher value in the serosa than in the mucosa. This tendency was not evident in differentiated type adenocarcinoma but was noted in those with the undifferentiated type. There were 37 tumors (80.0%) with the same DNA distribution pattern in every layer of the stomach (homogeneous DNA ploidy). Heterogeneity of DNA ploidy was observed in nine tumors (20.0%). Carcinoma with heterogeneous DNA ploidy manifested a significantly higher incidence of metastasis to lymph nodes than did those with the homogeneous type. Characteristically, there was venous permeation preponderance in the differentiated type and peritoneal dissemination preponderance in the undifferentiated type. This evidence of DNA heterogeneity in gastric carcinoma tissue suggests a possible correlation with metastatic behavior.

Adenocarcinoma↗

PubMed1993

Laminin distribution patterns are closely related to liver metastasis in gastric cancer.

BACKGROUND: Laminin is the major glycoprotein of basement membrane and is known to have an important role in the metastatic process. METHODS: The authors used immunohistochemical techniques to evaluate the distribution of laminin-containing basement membrane in specimens from 157 patients with advanced gastric cancer. RESULTS: This membrane was found less frequently in the deep periphery than in the mucosa. According to our classification of distribution patterns, 39 (24.8%) tumors had laminin in the mucosa and the deep periphery of tumor (Group A); 37 (23.6%) tumors had laminin in the mucosa but not in the periphery (Group B); and in 81 (51.6%) tumors laminin was not found in the mucosa or the periphery (Group C). Tumors with laminin in the deep periphery (Group A) were characterized by expansive growth (P < 0.05), and there was a significant correlation with the occurrence of vessel invasion (P < 0.05) and liver metastasis (P < 0.01). Patients with Group A tumors had poor prognosis compared with patients with Group C tumors (P < 0.05). Multivariate logistic regression analysis showed laminin distribution patterns to be an independent value for predicting liver metastasis, as are lymph node involvement and expansive growth. CONCLUSION: The authors propose that laminin-positive basement membrane in the deep periphery in gastric cancer tissue is a significant risk factor for liver metastasis. For such high-risk patients, close follow up and postoperative adjuvant therapy are required.

Basement Membrane↗

PubMed1993

Diagnostic factors in gastric cardia cancer invading the esophagus.

BACKGROUND: The prognosis of patients with tumors in the upper one-third of the stomach, particularly those with esophageal invasion, is poor. METHODS: This study involved 168 patients with advanced cancer in the upper third of the stomach whose lesion had had invaded the esophagus. Clinical and pathologic studies were performed with respect to diagnostic factors and histologic differentiation of the lesion. RESULTS: Eighty-three patients (49.4%) had differentiated gastric cancer, and 85 (50.6%) had undifferentiated cancer. The survival time was shorter for patients with undifferentiated cancer than for those with differentiated cancer (P < 0.01). Multivariate analysis showed operative curability, liver metastasis, peritoneal dissemination, lymph node metastasis, serosal invasion, and tumor size to be independent prognostic factors. In patients with undifferentiated cancer, tumors were larger, serosal invasion was prominent, lymph node metastasis was present in 85.9% of cases, 64.7% of metastases were noncuratively resected, and survival time was less favorable. CONCLUSIONS: Our analysis shows that a group of patients at increased risk for tumor advancement will benefit from more aggressive therapy.

Adult↗

PubMed1993

Prognosis for patients with carcinoma in the middle third of the stomach.

In 268 of the 1,115 patients (24.0%) with gastric cancer who underwent a curative resection in our clinics, the tumor was located in the middle third of the stomach. The clinicopathological features and prognosis of these patients were divided into two groups, according to site of the tumor: anterior wall (n = 58) vs. other sites (n = 210). Clinicopathological factors did not differ between the two groups. The survival time for patients with a tumor in the anterior group was shorter than that for patients with a tumor in other areas (P < 0.05). The five-year survival rate was 79.3% for patients with an anterior tumor and 91.9% for those with a tumor at a different site. A multivariate analysis indicated lymph node metastasis, serosal invasion, and anterior wall location to be independent prognostic factors indicative of a poor prognosis when the tumor was located in the middle third of the stomach. For such patients, close follow-up is needed to detect possible recurrences.

Female↗

PubMed1993

Anterior spinal artery syndrome.

Three patients with symptoms due to the anterior spinal artery syndrome were treated by direct perfusion of dexamethasone sodium phosphate and urokinase into the artery of Adamkiewicz. Their symptoms were paraparesis with dissociated sensory loss and sphincter dysfunction, and there was no evidence of the possible cause. In the early phase of the disease, three consecutive injections were carried out with an interval of a week between each. All the patients made a good recovery.

Adolescent↗

PubMed1993

An unusual ossified thoracic disc herniation.

We report an unusual ossified thoracic disc herniation occurring in a man, aged 69 years. The ruptured disc formed a large mass occupying the entire spinal canal at the T8-T9 intervertebral level. Histology confirmed that this was an ossified disc with mature bone tissue. He improved after decompression through a posterolateral approach.

Aged↗