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Biomedical subjects

H Hashimoto

Publications and source records attributed to H Hashimoto.

At least 811 records · Page 45Linked to original sources
PubMed1992

Mechanism of extracellular ATP-stimulated phosphoinositide hydrolysis in rat glioma C6 cells.

In rat glioma C6 cells, extracellular ATP stimulated phosphoinositide (PI) hydrolysis in concentration- and time-dependent manners with a median effective dose value of 60 microM. The maximal response was attained at 300 microM ATP. Of adenine nucleotides, ATP and adenosine 5'-O-(3-thiotriphosphate) were most effective, while adenosine, AMP and beta,gamma-methylene ATP were ineffective. Similar results were obtained in cultured rat astrocytes. The stimulatory effects of ATP and ADP were negated by removal of external Ca++ in C6 cells. ATP at 300 microM induced an elevation of intracellular Ca++ concentration in 1-[2-(5-carboxyoxazol-2-yl)-6-amino-benzofuran-5-oxy]-2-(2'-amino- 5'- methylphenoxy)-ethane-N,N,N',N' acid-loaded C6 cells. This response was not blocked by nifedipine (10 microM) and verapamil (10 microM). A Ca++ ionophore A23187 (10 microM) stimulated PI hydrolysis in C6 cells. The responses to ATP (300 microM) and A23187 (10 microM) were additive. In digitonin-permeabilized C6 cells, Ca++ at the concentration of 100 microM evoked PI hydrolysis, and ATP alone did not affect the Ca++ dependence. GTP gamma S (100 microM) stimulated the PI hydrolysis at a range of 0.1 to 10 microM Ca++, and ATP enhanced the GTP gamma S response in the permeabilized cells. These results suggest that activation of P2-purinergic receptors by ATP causes phospholipase C to be activated by subthreshold concentrations of Ca++ via GTP-binding proteins, resulting in an activation of the enzyme in response to stimulated Ca++ influx.

Adenosine Triphosphate↗
PubMed1992

[AFP producing gastric cancer manifested by metastasis to the tentorium cerebelli; case report and review of the literature].

We report a case of AFP producing gastric cancer manifested by metastasis to the tentorium cerebelli. A 66-year-old male patient was admitted with dysarthria, occipital headache and nausea on May 1, 1990. Neurological examination revealed signs of increased intracranial pressure and the right-sided cerebellar hemispheric signs. CT and MRI showed a round tumor shadow 3cm in diameter, which originated in the right-side tentorium cerebelli and grew in the posterior fossa. Tumor stains fed by the right tentorial artery were recognized by angiography. Serum AFP level was 503.5ng/ml. The patient underwent an operation under general anesthesia in the prone position. The tumor was totally removed via the suboccipital transtentorial approach. Histological examination revealed AFP producing adenocarcinoma. The patient was found to have a gastric cancer after neurosurgical operation, and underwent subtotal gastrectomy by surgeons. Serum AFP level was 254.5ng/ml after removal of metastatic brain tumor, and 5.0ng/ml after subtotal gastrectomy.

Adenocarcinoma↗
PubMed1992

[Studies on criteria for clinicopathological diagnosis of allergic granulomatous angiitis (AGA)].

Comparative studies in the evaluation of criteria for clinicopathological diagnosis of AGA which was proposed by Japanese Health and Welfare Ministry (JHWM) in 1988 and American College of Rheumatology (ACR) in 1990 were conducted. Twenty seven Japanese patients with AGA and 231 Japanese controlled patients with polyarteritis nodosa (PAN) and Wegener's granulomatosis (WG) were used as material patients who had been provided a second questionnaire in 1984 sponsored by the JHWM. As a result, the JHWM criteria was 85.2% in sensitivity and 96.5% in specificity, which was superior to the ACR criteria being 74.1% in sensitivity and 93.9% in specificity. These results were due to the low sensitivity and low accuracy in paranasal sinus abnormality and pulmonary infiltrates which were included in the ACR criteria. Furthermore, the JHWM criteria could be diagnosed as AGA using not only the histopathological findings but by the clinical symptoms alone. The controlled patients who were overdiagnosed as AGA using ACR criteria were thought to be included as patients with WG. On the other hand, the controlled patients who were overdiagnosed as AGA using JHWM criteria were thought to be included as patients with overlap syndrome of AGA and PAN. Accuracy of polyneuropathy, muscle weakness, melena and pretibial edema were over 60%, indicating that these clinical symptoms were available for vasculitis symptoms of the JHWM criteria.

Churg-Strauss Syndrome↗
PubMed1992

[Clinical study on total intravenous anesthesia with droperidol, fentanyl and ketamine--15. Application for cardiac anesthesia].

Total intravenous anesthesia with droperidol, fentanyl and ketamine (DFK) was administered to 36 cardiac patients who underwent mostly coronary artery bypass graft or heart valve replacement. The induction and maintenance of anesthesia using this technique were almost satisfactory with little decrease in systolic blood pressure (SBP), although six patients among the early 21 patients developed hypotension below 90 mmHg (SBP) during the induction, and required vasopressors. Half of the patients had hypertensive episode of above 180 mmHg (SBP), from the start of operation to onset of cardiopulmonary bypass, which was safely and effectively overcome by a small dose of antihypertensive agents. Total intravenous anesthesia with DFK was accompanied with much more hypertensive episodes compared to anesthesia with moderate dose fentanyl (30 micrograms.kg-1) combined with enflurane. However, the incidence of cardiovascular complications following anesthesia was not statistically different between the two anesthesia groups. In addition, most of the patients with DFK showed a rapid awaking time with relatively good postoperative cardiovascular stability. These findings suggest that total intravenous anesthesia with DFK is accompanied with minimal hemodynamic changes during and after open heart surgery.

Aged↗
PubMed1992

Effect of high-dose methotrexate on plasma hypoxanthine and uridine levels in patients with acute leukemia or non-Hodgkin lymphoma in childhood.

We investigated the effect of high dose methotrexate (HDMTX) therapy on plasma hypoxanthine (Hx) and uridine (UR) concentrations in 12 children with acute lymphoblastic leukemia (ALL) or non-Hodgkin lymphoma (NHL). The initial plasma Hx level before the first administration of HDMTX (1 g/m2) was significantly higher in patients (25.5 +/- 17.5 microM) than that in healthy adult controls (4.0 +/- 1.4 microM). By 48 or 72 hours after the beginning of MTX infusion, the Hx concentration had decreased to 7.9 +/- 7.7 microM and 4.7 +/- 4.1 microM, respectively. This decrease of plasma Hx concentration after MTX infusion was also observed with the second course of HDMTX (3 g/m2) therapy. On the other hand, the plasma UR level did not change significantly. The in vitro treatment with 2 microM MTX of hypoxanthine-guanine phosphoribosyltransferase (HGPRT)-deficient mutant cells selected from HL-60 lowered the excretion of Hx into the culture medium. These data suggest a possible new explanation of the synergism of HDMTX and 6-thiopurines, for example 6-mercaptopurine and 6-thioguanine, since plasma Hx is considered to counteract 6-thiopurine toxicity through competition at the level of HGPRT.

Adolescent↗
PubMed1992

[Two cases of idiopathic pulmonary hemosiderosis: analysis of chest CT findings].

Chest CT findings are reported in two cases of idiopathic pulmonary hemosiderosis. In both cases, CT was performed after remission of an acute exacerbation following corticosteroid therapy. Case 1 was a 17-year-old woman with Down's syndrome. Chest radiograph showed diffuse ground-glass like and reticulonodular shadows, which were predominant in the bilateral lower lung fields. Chest CT showed a diffuse increase of lung filed density, especially in the dorsal zone of both lower lobes. Open lung biopsy revealed hemorrhage and numerous hemosiderin-laden macrophages in the alveoli, and in addition, marked fibrous thickening of the alveolar septa. Case 2 was a 7-year-old girl. Chest radiograph showed diffuse micronodular shadows in both lungs. Chest CT showed diffuse poorly-circumscribed micronodular lesions with uniform distribution, and lung field density was normal except for the right upper lobe with patchy infiltrates. Although lung biopsy was not performed, fibrous thickening of the alveolar septa was presumed to be mild even if present, since pulmonary function and blood gas analysis were within normal limits. In these two cases, lung field density of CT seemed to reflect the degree of diffuse fibrous thickening of the alveolar septa, and it is suggested that CT is valuable in the evaluation of fibrous thickening of the alveolar septa secondary to recurrent pulmonary hemorrhages. Comprehensive review of CT findings of idiopathic pulmonary hemosiderosis was also performed.

Adolescent↗
PubMed1992

Studies on the outcome of lupus nephritis according to long-term treatment employing different modes of immunotherapy.

The outcome of long-term treatment of lupus nephritis under different immunotherapies, together with the factors affecting the outcome of lupus nephritis, was studied. A total of 212 lupus nephritis patients were classified into 5 groups according to their different modes of treatment: (1) initial dose of prednisolone (PSL) below 39 mg/day, (2) initial dose of PSL above 40 mg/day, (3) pulse therapy and steroids, (4) steroids and immunosuppressants, and (5) combination therapy of plasmapheresis with other therapies. The outcome of lupus nephritis was evaluated into 5 grades. As a result, the complete remission rate of lupus nephritis was 9.4%. The 5-year survival rates increased with all modes of treatment. However, it was impossible to identify which mode of therapy could bring about the highest rate of remission. Decreases in extrarenal involvement and low complement levels were observed together with increases in IgM anti-DNA antibodies among the lupus nephritis patients with remission.

Adolescent↗
PubMed1992

[Clinical spectrum of antibiotic associated enterocolitis due to methicillin resistant Staphylococcus aureus].

Historically, various types of antibiotic-associated diarrhea have been recognized. In the 1950-1960s, multi-resistant Staphylococcus aureus was implicated to be major cause of antibiotic-associated diarrhea, especially pseudomembranous enterocolitis. In the late 1970s, a new type of antibiotic-associated diarrhea, which is characterized by pseudomembranous colitis and lack of fecal multi-resistant S. aureus, usually following lincosamide administration, was recognized. Many studies have revealed the pathogenic roles of Clostridium difficile in these patients. Recent emergence of methicillin resistant S. aureus (MRSA) provokes another type of antibiotic-associated diarrhea. We have tried to isolate S. aureus and C. difficile from 150 faecal samples of patients with antibiotic-associated diarrhea. S. aureus alone was isolated from 32 (21.3%) samples. C. difficile alone was isolated from 51 (34.0%) samples, and, both were detected in 23 (15.3%) samples. 90.9% of S. aureus were MRSA. Comparing the clinical features of these cases, patients with both C. difficile and MRSA showed more serious clinical features. The patients who had undergone laparotomy were accompanied by shock and meteorism, more often than patients without laparotomy. The management of antibiotic-associated diarrhea due to MRSA is discussed.

Aged↗
PubMed1992

Carcinoid tumor arising in the wall of a congenital bile duct cyst.

We report an extremely rare case of carcinoid tumor arising in a congenital choledochal cyst. The dilated choledochal cyst in a 66-year-old Japanese woman was surgically resected, after which the ovoid elevated tumor, measuring 1.5 x 1.5 cm, was detected in the proximal portion of the cyst. A carcinoid tumor was histologically confirmed. To the best of our knowledge, this is the first published case of carcinoid tumor in a choledochal cyst.

Aged↗
PubMed1992

Carcinoid tumor of the pancreas with obstructive pancreatitis.

A case of primary pancreatic enterochromaffin cell (EC cell) carcinoid tumor in a 66-yr-old Japanese man is presented. The markedly dilated main pancreatic duct was noticed at the time of an incidental ultrasonogram during hospitalization for diabetes mellitus. Endoscopic retrograde pancreatography showed stenosis of the main pancreatic duct at the body of the pancreas and dilated pancreatic ducts distal to the obstruction. A distal pancreatectomy was performed, together with splenectomy. Macroscopically, the main pancreatic duct was compressed by a fibrous mass around the duct, and the pancreatic ducts distal to the tumor were markedly dilated. Histologically, the tumor was composed of uniform round cells, proliferating in small nests or trabeculae. The tumor cells were strongly positive with both Grimelius and Fontana-Masson stains. The immunohistochemical study disclosed the tumor cells to be positive for serotonin and chromogranin. This is a rare case of primary pancreatic EC cell carcinoid tumor with obstructive pancreatitis.

Aged↗
PubMed1992

[Plasmapheresis for patients with RA].

Effect of plasmapheresis for patients with rheumatoid arthritis. Plasmapheresis for rheumatoid arthritis (RA) was performed more than ten years, but efficacy of plasmapheresis was not done. In this paper, we discussed efficacy, indications and procedures. We have many procedures of plasmapheresis, 1) plasma exchange, 2) double filtration plasmapheresis, 3) cryofiltration plasmapheresis, 4) immunoadsorption plasmapheresis, 5) salt-amino acid coprecipitation plasmapheresis, 6) lymphocytapheresis, 7) lymphocyte-plasmapheresis, 8) photopheresis. Indications of plasmapheresis for RA are 1) malignant RA, 2) high activity of RA, 3) positive circulating immune complexes, 4) patients can't take steroid hormone or anti-inflammatory drugs. Efficacy of plasmapheresis for RA was not done, then, we must have controlled study about efficacy of plasmapheresis for RA.

Arthritis, Rheumatoid↗
PubMed1992

[Studies on clinical subsets and severity of systemic lupus erythematosus based on a 1987 questionnaire conducted in Japan--clinical analysis of the outcome and treatments in clinical subsets].

A 1987 questionnaire sponsored by the Health and Welfare Ministry concerning the clinical subsets and severity of systemic lupus erythematosus (SLE) was distributed to 93 medial facilities. A clinical analysis of the outcome and treatments was accomplished on one thousand six hundred and fourteen SLE patients fulfilling ARA criteria. The outcome was evaluated into 6 categories, namely; complete remission, incomplete remission, no change, gradual worsening, rapid worsening and unknown. Treatments included (1) anti-inflammatory drugs, (2) initial dose of prednisolone (PSL) below 29 mg/day, (3) initial dose of PSL from 30 to 59 mg/day, (4) initial dose of PSL above 60 mg/day, (5) pulse therapy, (6) immunosuppressants, (7) plasmapheresis, and (8) hemodialysis. Statistical significances were determined with ridit analysis. The severity of the disease for 1,614 SLE patients was evaluated by the judgement of each medical facility independently, separating it into 3 grades. As a result, 16.8% was evaluated as severe, 54.6% was evaluated as moderate, and 28.6% was evaluated as mild. Clinical subsets were divided into 3 categories according to the outcome; (1) those with high complete remission rates (serositis, convulsion, oral ulcers, unconsciousness, hemolytic anemia and so on), (2) those with high incomplete remission rates (lupus nephritis, digital gangrene, hypertension, peripheral neuropathy, erythema, Raynaud's phenomenon and so on), and (3) those with high rates of no change or worsening (aseptic bone necrosis, pulmonary hypertension, pneumonitis, chronic renal failure and so on). SLE patients with persistent proteinuria below 3.4 g/day, pulmonary hypertension, or pneumonitis treated with large doses of PSL such as an initial dose of PSL above 60 mg/day and/or pulse therapy had a significantly higher remission rate than those treated with small dosages of PSL. Hereafter, the establishment of modes of treatments for increasing the remission rates of intractable clinical subsets in highly desired.

Adolescent↗
PubMed1992

[A case of multilocular renal cell carcinoma].

Herein we report case of multilocular cyst of the right kidney complicated with clear cell type renal cell carcinoma. The chief complaint of the 51-year-old male patient was macroscopic hematuria. He underwent radical nephrectomy and was administered postoperative adjuvant chemotherapy with alpha-interferon. No recurrence was found 18 months after operation. Pathogenesis of multilocular cyst of the kidney and the mechanism of malignant transformation are discussed.

Carcinoma, Renal Cell↗
PubMed1992

[Primary carcinoma in diverticulum of the bladder: a report of three cases].

The first case was in a 48-year-old man admitted with a chief complaint of macroscopic hematuria and sense of residual urine. A tumor in the diverticulum of the bladder was detected by cystoscopy, computed tomography (CT) and magnetic resonance imaging (MRI). We made the diagnosis of an invasive tumor in the diverticulum of the bladder. Total cystourethrectomy and ileal conduit diversion was performed. Histopathological finding was transitional cell carcinoma including squamous cell carcinoma. Adjuvant chemotherapy was performed. No recurrence and metastasis has been recognized for 12 months. The second case was a 56-year-old man having an intradiverticular tumor diagnosed by cystoscopy, CT, and MRI. Total cystectomy and ileal conduit diversion was performed. Histopathological findings was squamous cell carcinoma. No recurrence has been recognized for 8 months. The last case was an 81-year-old man. The patient had the complication of a primary progressive squamous cell carcinoma of the skin. Transurethral resection of diverticular tumor was performed under the diagnosis of superficial tumor. Histopathological findings revealed transitional cell carcinoma. One hundred and sixty one cases of tumor in the diverticulum of the bladder were reviewed. Importance of aggressive treatment including total cystectomy was emphasized.

Aged↗
PubMed1991

[MR-angiography of veins in the lower extremities].

Phase contrast MR-angiography (MRA) of veins in the lower extremities was performed in 10 healthy volunteers and 2 patients with deep vein thrombosis of the lower extremities. In all volunteers, MRA demonstrated bilateral large saphenous veins, femoral veins and popliteal veins. Deep veins in the leg were visualized in only 3 out of 20 legs examined, but with compression of the thigh they were visualized in 4 out of 7 legs subjected to compression. In patients with deep vein thrombosis, obstruction of the femoral veins and development of the collateral veins were clearly visualized. It is concluded that MRA may be a valuable technic for the evaluation of the veins patency in the lower extremities.

Humans↗