Urine thrombomodulin in patients with idiopathic pulmonary fibrosis.
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Aged↗
Biomedical subjects
H Goto
Publications and source records attributed to H Goto.
Preventive effects of dehydroepiandrosterone acetate on the fatty liver induced by orotic acid in male rats.
Preventive effects of dehydroepiandrosteone acetate (DHEA-A) and clofibrate (positive control substance) on the fatty liver induced by orotic acid (OA) were examined on the male Sprague-Dawley rats fed a high sucrose based diet containing 1% OA and this diet further mixed with 0.5% DHEA-A or 0.5% clofibrate for 2 weeks. Numerous lipid droplets were observed in the hepatocytes of the rats treated with OA alone, but not in those treated with DHEA-A or clofibrate. In comparison to the group with OA alone, the DHEA-A or clofibrate treated rats showed a larger relative liver weight (to body weight) which was accompanied by increased peroxisomes in the hepatocytes. These results indicate that DHEA-A, as well as clofibrate, may prevent OA-induced fatty liver.
Animals↗
Myositis ossificans in the tip of the thumb: a case report.
A case of a myositis ossificans occurring in the distal portion of the finger is reported. An 18-year-old female noticed a small nodule in the tip of the left thumb for 11 months. Plain radiographs showed calcified shadow and there was a radiolucent zone between the mass and the distal phalanx. The excised mass was diagnosed as myositis ossificans. To our best knowledge, there has been no report of a myositis ossificans in the tip of the finger in literature.
Adolescent↗
Oxygen carrying capacity and oxygen supply rate of artificial oxygen carrier, Neo Red Cell (NRC).
Neo Red Cell (NRC), which is the liposome encapsulated hemolysate, has been developed as an artificial oxygen carrier. Oxygen carrying capacity and oxygen supply rate of NRC were estimated by continuous measurement of dissolved oxygen concentration in a spinner vessel. Oxygen carrying capacity of the medium was risen by adding NRC. The oxygen supply rate of the NRC medium containing hepatocytes was determined by the oxygen consumption rate of hepatocytes. The addition of NRC gave no effect on the oxygen transfer rate from gas phase to liquid phase (or kL a value) of the solution in the spinner vessel. The rate of oxygen absorption to NRC was limited by the oxygen transfer rate from gas phase to liquid phase in the spinner vessel. These results indicate that the oxygen supply from NRC may sustain the high-density culture of mammalian cells.
Air↗
Assessment of the oxygen transport capacity of NRCs with a 70% blood exchange in rats.
Neo red cells (NRCs) are a blood substitute representing stroma free hemolysate (SFHL) encapsulated in liposomes and containing NAD, glucose, adenine, and inosine, etc. as substrates or coenzymes of the Embden-Meyerhof pathway in RBCs and inositol hexaphosphate (IHP) as an allosteric effector. The oxygen transport efficiency (OTE) of NRCs was increased to > 45% when the oxygen partial pressure in arterial blood increased. We carried out exchange transfusion with NRCs in rats, monitored their functioning as a blood substitute in vivo, and demonstrated that NRCs worked sufficiently. First, we confirmed that the OTE of NRCs was augmented by increasing the oxygen supply to the rats by using oxygen masks. Second, we carried out 70% blood exchange with NRCs (with hemoglobin concentrations of 4, 5, 6, or 7 g/dl), and compared these experimental groups with control groups (RBC and saline). Each sample was contained bovine albumin (final volume of 5% (w/v)). As a result, the NRC groups with hemoglobin concentrations of 5, 6, and 7 g/dl showed stability after the exchange transfusion. On the other hand, the NRC group with hemoglobin concentration of 4 g/dl and the saline group showed respiratory acidosis and a drop of blood pressure and heart rate, and thus did not maintain an adequate oxygen supply. We concluded that a hemoglobin concentration of > 5 g/dl was sufficient in the NRC solution, and demonstrated in an experiment on animals that the OTE of NRCs was increased by using oxygen masks.
Administration, Inhalation↗
[Study on the relationship between tumour necrosis factor gene polymorphism and prognosis in the patients with renal cell carcinoma].
BACKGROUND: Clinical significance of polymorphism of tumour necrosis factor (TNF) genes encoded on the short arm of the 6th chromosome in the patients with renal cell carcinoma (RCC) has not been evaluated well so far. We studied on the TNF genes polymorphism of RCC focusing on the relationship between the genetic polymorphism and the prognosis. METHODS: The subjects were seventy-three patients with RCC treated at our hospitals during the past 20 years. The genomic DNA was examined by the methods of polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) from frozen peripheral blood of these patients. The items examined were the genetic polymorphisms of TNF-alpha (alpha 1, alpha 2) and TNF-beta (beta 1, beta 2), and we tried to study on the prognostic outcome of RCC based upon each zygote of TNF. RESULTS: 1) The proportion of TNF-alpha and TNF-beta polymorphisms: We observed TNF-alpha 1/1 homozygote in 71 patients (97.3%). As to TNF-beta polymorphism, we observed TNF-beta 2/2 homozygote in 33 patients (45.2%), TNF-beta 1/2 heterozygote in 31 (42.5%) and TNF-beta 1/1 homozygote in 9 (12.3%). The proportion of TNF-beta polymorphism was almost the same as that of healthy Japanese. 2) PROGNOSIS: Regarding the 17-year survival, all patients with TNF-beta 1/1 homozygote were alive, and we observed a significantly favourable prognosis in the patients with TNF-beta 1/1 homozygote compared with other zygotes of TNF-beta polymorphism. The reasons for these favourable prognosis were thought that the patients with TNF-beta 1/1 homozygote showed much lower stage and/or grade than those of other zygotes. CONCLUSION: We conclude that the TNF-beta gene polymorphism is a useful marker for understanding the prognosis of RCC and a part of cellular immunity related to the tumour and its host.
Adult↗
[Study on the relationship between vascular invasion and prognosis in patients with locally confined renal cell carcinoma].
BACKGROUND: There exists controversy concerning the relationship between the vascular invasion and the prognosis in the locally confined renal cell carcinoma (RCC). We have tried to study on the relationship between the vascular invasion and the prognosis in these patients. METHODS: Of the five hundred and forty-eight patients with RCC who did not have lymph node and distant metastasis, the 464 patients without having the micro- and/or macro-vascular invasion (tumour thrombus) were analysed as the control, and the remaining 85 with micro- and/or macro-vascular invasion were subject to this study. RESULTS: There observed a significantly favourable prognosis in the patients with RCC who did not have the vascular invasion (pV0) compared with the patients who had the vascular invasion (pV1a: n = 43, P = 0.00068, pV1b: n = 34, 0 < P < 0.00006, pV2: n = 8, P = 0.012). Furthermore, the patients with pV1a showed a significantly favourable prognosis compared with the patients with pV1b (p = 0.00032), and the patients with pV2 (0 < P < 0.00006), and the patients with pV1b (P = 0.00032), and the patients with pV2 (0 < P < 0.00006), and the patients with pV1b also showed a significantly favourable prognosis compared with the patients with pV2 (0 < P < 0.0006). As to the relationship between the tumour size and vascular invasion (V-stage) the tumour size got larger along with the elevation of the V-stage, and there also observed a significant difference of the tumour size between the patients with pV10 and pV1a (P = 0.00578), with pV0 and pV1b (0 < P < 0.000061) and pV0 and pV2 (P = 0.0002). The same result was obtained in the relationship between the localization of the tumour and prognosis, i.e., the patients with pV2 showed a higher frequency of larger occupation of the tumour within the kidney compared with other V-stage patients. Regarding the recurrence rate, there observed a tendency toward high frequency of recurrence along with the elevation of V-stage. Furthermore, there observed an untoward relationship between the elevation of the V-stage and the periods of recurrence after nephrectomy. In an effort to analyse the disease-free survival, there observed a significant difference among the patients with pV0, pV1a, pV1b and pV2. CONCLUSION: We conclude that the vascular invasion is a very important prognostic factor in the patients with locally confined RCC. Furthermore, along with the elevation of the V-stage, it directly reflects the poorer prognosis.
Carcinoma, Renal Cell↗
[Study on the combined therapy of DNA-methyltransferase inhibitor and interferon-alpha/beta for mouse spontaneously arose renal cell carcinoma, and immunological mechanism induced by the therapy].
BACKGROUND: In order to change the immunological environment of T-helper2 (Th2) predominance, namely humoural immunity, in renal cell carcinoma, we tried to examine the efficacy of combined treatment with DNA-methyltransferase inhibitor (Procainamide) and interferon (IFN)-alpha/beta in basic experiments, and also examined the immunological mechanism induced by this treatment modality. MATERIALS AND METHODS: The monotherapy of Procainamide (10 mg/kg, 20 mg/kg, 30 mg/kg, everyday for 3 weeks, i.p.) and of natural murine IFN-alpha/beta (1 x 10(4) I.U./mouse, 3 times for a week, total 9 times, s.c.), and combined treatment with these 2 drugs for mouse spontaneously arose renal cell carcinoma (RC-2) were undertaken. Furthermore, we examined the expression of cytokine mRNA related to the Th-subset in murine spleen under the tumour burden by the RT-PCR methods. RESULTS: 1) Regarding the anti-tumour efficacy of two kinds of monotherapy (Procainamide and IFN-alpha/beta), no effective result was obtained. On the other hand, the combined treatment with these two drugs induced effective anti-tumour efficacy in the relative mean tumour weight ratio (TRW/CRW), mean tumour weight and the survival rate compared with the control and each monotherapy, especially in the administration of Procainamide dosed at 30 mg/kg. As to the histological degeneration induced by the combined therapy, there still remained the viable tumour cells (grade IIb). 2) In an effort to analyse the immunological changes induced by the administration of Procainamide, there observed the expression of Th1-derived cytokines mRNA such as IFN-gamma, IL-2 and tumour necrosis factor-beta, and except for interleukin (IL)-10, there also observed the disappearance of Th2-derived cytokines mRNA such as IL-4, IL-5 and IL-6 in the murine spleen. CONCLUSION: We draw the conclusion that the treatment with DNA-methyltransferase inhibitor may change the humoural immunological environment into the cellular immunological environment enabling the effective anti-tumour efficacy combined with IFN-alpha/beta in renal cell carcinoma.
Animals↗
Usefulness of intraductal ultrasonography in gallbladder disease.
This study was designed to compare intraductal ultrasonography of the gallbladder wall with histopathologic findings and to assess the clinical usefulness of this imaging method in gallbladder disease. Thirty-one gallbladder specimens were examined by intraductal ultrasonography retrospectively. The gallbladder is composed of three layers: an innermost hyperechoic layer, a middle hypoechoic layer, and an outermost hyperechoic layer. The second layer on ultrasonograms corresponds to the muscle layer plus the fibrous tissue of the superficial perimuscular connective tissue layer. In cases in which the thickness of the second layer was 500 microns or less, little fibrous tissue was seen and the second layer was approximately identical to the muscle layer on sonograms. Clinical study was performed on 22 gallbladders. The use of a guidewire through the papilla facilitated intraductal ultrasonographic examination. The intraductal sonographic probe could be inserted into the gallbladder fundus in 13 of 22 cases. In nine unsuccessful cases, technical difficulties were as follows: sharply angulated gallbladder (four cases), stenosis of the gallbladder (two cases), difficulty in transmitting power in the correct direction (three cases). With regard to the area visualized in 13 successful cases, in three cases the area visualized was 100%, in seven cases it was 75%, and three cases it was 50%. Intraductal ultrasonographic images could be obtained in 83.3% (10 of 12) of elevated lesions of the gallbladder. The indications for intraductal ultrasonography will be cases in which an abnormality was detected by transabdominal ultrasonography or other modalities in which the physician does not know whether or not to operate. In conclusion, we defined the intraductal sonographic images of gallbladder wall and clarified the clinical indications for use of this imaging method.
Gallbladder↗
[Acute promyelocytic leukemia accompanied by scrotal Fournier's gangrene during ATRA treatment and relapsed as external ear tumor].
A 43-year-old man was admitted because of gingival bleeding. A diagnosis of acute promyelocytic leukemia (APL) was made. He was given combination chemotherapy including all-trans retinoic acid (ATRA). During the myelosuppression stage, the patient developed Fournier's gangrene of the scrotum. He achieved complete remission and underwent a hemicastration procedure. Seven months later, bilateral external ear tumors developed. Biopsy specimens of the tumors revealed infiltration of APL cells. A second remission was obtained by chemotherapy including ATRA. However, bilateral ear tumors developed again 5 months later despite indications of normal marrow without proliferation of leukemic blasts. Irradiation successfully reduced the ear tumors, but the patient died of cerebral hemorrhage from a left frontal extramedullary tumor. This was a rare case of APL accompanied by Fournier's gangrene of the scrotum during ATRA treatment, and by extramedullary tumors of the external ear and brain during leukemic relapse.
Adult↗
[Measurement of thrombomodulin values in the serum and eyes of experimental autoimmune uveoretinitis].
Thrombomodulin (TM) is a protein, present on intact endothelial cell surfaces, that plays a major role in the protein C anticoagulant system. Plasma TM is produced by injured endothelium, and is recognized in circulating blood or urine as a sign of endothelium cell damage. The localization of TM within the eye and its kinetics in the eye and the serum were investigated in rats with experimental autoimmune uveoretinitis (EAU). An immuno-histochemical study showed the presence of TM at sites of fibrin in the anterior chamber and retinal vasculitis. The amount of TM in the eye increased with progression of intraocular inflammation, but the serum level of TM did not significantly differ from the values in the control group. These data suggest that TM may play a role in preventing thrombosis in cases of vasculitis and fibrin formation in the anterior chamber in EAU, thus maintaining blood flow and the fluidity of aqueous humor.
Animals↗
[A case of pyogenic granuloma in the cervical esophagus].
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Esophageal Diseases↗
[Two cases of two-year-old girls with hypoxic ischemic encephalopathy induced by convulsive status].
We reported two cases of two-year-old girls with hypoxic ischemic encephalopathy. Their symptom was coma induced by seizures with respective factors. CT image on subacute stage showed the decreased density of the whole brain except for the primary sensorimotor cortex and the occipital lobe. MRI and CT images on chronic stage revealed generalized atrophy with no abnormal density areas. 99mTc-ECD SPECT on chronic stage showed low perfusion in the whole brain except for the primary sensorimotor cortex and the occipital lobe, in which areas brain tissue is considered to be injured easily in hypoxic ischemic encephalopathy. The paradoxical distribution of abnormal cerebral perfusion areas in our cases was reported in this paper.
Brain↗
[5-S-cysteinyldopa as a tumor marker for primary uveal malignant melanoma].
The clinical significance of 5-S-cysteinyldopa (5-S-CD), a major intermediate in melanin synthesis, was evaluated as a potential diagnostic tumor marker for uveal melanoma. Serum concentrations of 5-S-CD in 6 out of 7 patients with uveal melanoma in the absence of extraocular metastases were close to those of controls. In contrast, serum concentrations of 5-S-CD were found to be elevated in 3 patients with systemic metastases of melanoma. In addition, 5-S-CD in intraocular fluids, including both aqueous and vitreous humor, was elevated in patients with uveal melanoma regardless of the presence or absence of systemic metastases. These results suggest that 5-S-CD in the intraocular fluid may serve as a useful biochemical marker for the diagnosis of uveal melanoma.
Adult↗
Dilatation of sealed Dacron vascular prostheses: a comparison of Gelseal and Hemashield.
OBJECTIVE: Early postoperative dilation of a gelatin-impregnated knitted dacron prosthesis (Gelseal, Vascutek) and a collagen-impregnated woven Dacron prosthesis (Hemashield, Meadox Medicals) was studied. EXPERIMENTAL DESIGN: Prospective study. SETTING: Institutional clinical research. MATERIALS AND METHODS: A total of 30 patients who underwent aortic repair for abdominal aortic aneurysm with a Gelseal (n=15) or Hemashield (n=15) were studied. Prior to and immediately following implantation, the diameter of each graft was measured with slide calipers. The external diameter was examined by CT scan 4 weeks after surgery. Early dilation of Gelseal and Hemashield was estimated and compared. RESULTS: Prior to implantation, the external diameter of the Gelseal and Hemashield was 120% and 113% of the package size (PS), respectively, while the internal diameter was 103% and 102% of the PS, respectively. Following implantation, the external diameter of the Gelseal and Hemashield was 122% and 113% (immediately after) and 129% and 118% (4 weeks later) of the PS, respectively. CONCLUSIONS: The actual dilation rate for the first 4 weeks after implantation was estimated as 8% with the Gelseal and 4% with the Hemashield.
Aged↗
Routine coronary angiography prior to abdominal aortic aneurysm repair: incidence of silent coronary artery disease.
OBJECTIVE: Routine coronary angiogram (CAG) was performed in patients prior to elective repair of abdominal aortic aneurysm (AAA) to estimate the incidence of coronary artery disease (CAD) and to compare with risk factors for CAD and resting electrocardiogram (ECG). METHODS: History of CAD, risk factors for CAD, resting ECG, and standard CAG were assessed in 50 consecutive AAA patients. RESULTS: Nine patients had a history of CAD. Risk factors included: smoking in 82%, hypertension in 58%, hypercholesterolemia in 42%, and diabetes in 18%. CAG revealed that 46% of the patients had severe CAD with greater than a 75% stenosis of one or more coronary arteries. There was no relationship between the number of risk factors and prevalence of CAD. Eleven patients who had severe CAD as detected by CAG had no history of CAD and displayed no ischemic findings on ECG. No perioperative myocardial infarctions or angial attacks were noted despite the absence of prophylactic coronary interventions or revascularizations. CONCLUSIONS: The prevalence of severe CAD was 46% and incidence of silent CAD was 22% in this AAA population. The numbers of coronary risk factors and resting ECG were not worthwhile for predicting silent CAD.
Aged↗
Successful treatment of aortoesophageal fistula resulting from aneurysm of the aortic arch.
Aortoesophageal fistulas from primary thoracic aortic aneurysms are almost always fatal. In the English literature we have found only four successfully managed cases, all descending thoracic aortic aneurysms. We report an elderly woman who developed an aortoesophageal fistula from an aortic arch aneurysm. She was successfully managed with graft replacement including reattachment of arch vessels and a staged esophagectomy which was accompanied by mobilization of the omentum into the space between the esophagus and the prosthetic graft. She was the first successfully treated patient with aortoesophageal fistula resulting from aortic arch aneurysm.
Aged↗
Life-threatening reperfusion injury in skeletal muscle: a simple technique to control critical hyperkalemia.
A 55-year-old male suffering from acute abdominal aortic occlusion due to iatrogenic aortic dissection was urgently admitted to hospital. An axillo-bifemoral bypass was constructed 6 hours from the onset of dissection. Before and after revascularization, blood samples were repeatedly obtained from a systemic artery and femoral vein. The arterial potassium concentration gradually increased, reaching 7.3 mM/L. Oliguria and arrhythmias occurred, and the left lower limb became rigid 3 hours after reperfusion. The femoral artery and vein were clamped and within 30 minutes, the arterial potassium concentration fell to 4.8 mM/L. The urine output increased. The left lower limb was amputated, and the patient survived. Immediately following revascularization, hyperkalemia may occur. Clamping of the afferent and efferent vessels is recommended as a simple and practical technique to quickly control life-threatening hyperkalemia.
Amputation, Surgical↗