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Biomedical subjects

H Kameda

Publications and source records attributed to H Kameda.

At least 37 records · Page 2Linked to original sources
PubMed1997

[Successful treatment of toe gangrene with moderate-dose steroid therapy in a patient with systemic sclerosis (CREST syndrome)].

A 68-year-old woman first noticed Raynaud's phenomenon at the age of 35, and she was diagnosed as having systemic sclerosis (SSc) because of cutaneous calcinosis, sclerodactyly, telangiectasia, sausage-like finger, digital pitting scar in 1971. In October, 1994, she was suffered from cold sensation in her right foot, and on November 2 she noticed the painful ulcers on the right toe, which progressed to be gangrenous. Every antiplatelet or thrombolytic agents including PGE1, argatroban, sarpogrelate hydrochloride and urokinase were unsuccessful. Angiograms revealed marked narrowing of bilateral anterior and posterior tibial and peroneal arteries. Prednisolone 30 mg/day was started, which resulted in successful response within 10 days. Large vessel involvement in SSc patients has been reported to be rare, and its treatment remains to be established. We believe our case help understanding the pathophysiology of such rare manifestation in SSc.

Aged↗
PubMed1997

Clinical characteristics of patients with rheumatoid arthritis and methotrexate induced pneumonitis.

OBJECTIVE: To determine the clinical features of methotrexate (MTX) pneumonitis in patients treated for rheumatoid arthritis (RA). METHODS: The medical records of 284 patients with RA who had been treated with oral MTX (mean followup 33.2 mo) were reviewed retrospectively. RESULTS: MTX induced interstitial pneumonitis developed in 6 patients (2.1%). The affected patients were significantly older than those without MTX pneumonitis (67.3 +/- 9.8 vs 52.4 +/- 12.6 yrs, respectively; p < 0.005). The cumulative MTX dose ranged from 65 to 580 mg at the time pneumonitis developed. Five of the patients (83%) had preexisting interstitial abnormalities, while only 29 of the 278 patients without MTX pneumonitis (10%) had such abnormalities (p < 0.001). The frequency of adverse effects due to previous treatment with disease modifying antirheumatic drugs (DMARD) was 66.7% in MTX pneumonitis patients and 14.3% in the other 278 patients (p < 0.01). CONCLUSION: Advanced age, preexisting interstitial abnormalities, and previous adverse reactions to DMARD may be associated with MTX pneumonitis. Patients with these characteristics require careful monitoring during MTX therapy.

Adult↗
PubMed1996

The effect of alpha-linolenic acid-rich emulsion on fatty acid metabolism and leukotriene generation of the colon in a rat model with inflammatory bowel disease.

The purpose of this study was to investigate the efficacy of alpha-linolenic acid-rich perilla oil emulsion (POE) in a rat model with trinitrobenzenesulfonic acid (TNB)-induced inflammatory bowel disease. Three different isocaloric solutions, which are glucose solution (FF), soybean oil emulsion (SOE) and POE, were infused for 14 days after instillation of TNB. After infusion, total cholesterol and phospholipid concentration in the plasma in the POE group were significantly decreased compared with the FF and SOE groups. Arachidonic acid level in the colonic phospholipids was significantly decreased and eicosapentaenoic acid level was significantly increased in the POE group compared with the FF and SOE groups. Thickness, damage score and leukotriene B4 content in the colon in the POE group were the lowest among the infusion groups. These results suggest that alpha-linolenic acid suppresses the synthesis of leukotriene B4 in the colon by changing the fatty acid composition in the colonic phospholipids and that POE may be effective in the improvement of inflammation in the colon.

Animals↗
PubMed1996

The nutritional effect of a-linolenic acid-rich emulsion with total parenteral nutrition in a rat model with inflammatory bowel disease.

The purpose of this study was to investigate the nutritional effect of perilla oil emulsion (POE) in a rat model with inflammatory bowel disease (IBD) induced by 2,4,6-trinitrobenzenesulfonic acid. POE and soybean oil emulsion (SOE) were infused at 20% of nonprotein energy during 7 days' total parenteral nutrition (TPN). After infusion of test solutions, body weight gain and cumulative nitrogen balance in the POE group were significantly higher than those in the fat-free TPN (FF) group after infusion of test solutions. Moreover, those in the POE group were higher than those in the SOE group, but no significant difference was observed between the POE and SOE groups. In the POE group, total cholesterol and phospholipid concentration in the plasma was significantly decreased compared with the FF and SOE groups. Triglyceride concentration in the plasma did not significantly differ between the POE, SOE and FF groups. Plasma lipid peroxide concentration in the POE group was significantly lower than that in the SOE group, but it was not different from the FF group. In fatty acid composition in the plasma total lipids, linoleic acid in the POE and SOE groups and alpha-linolenic acid in the POE group were significantly increased compared with those in the FF group. Arachidonic acid (AA) in the POE and FF groups were significantly decreased compared with that in the SOE group. Otherwise, eicosapentaenoic acid (EPA) in the POE group was significantly increased compared with that in the SOE and FF groups. EPA/AA ratio in the POE group was significantly increased compared with the SOE group. The thickness and damage score of the colon were significantly depressed in the POE group compared with the SOE group. These results suggest that POE has a superior nutritional effect and improves inflammation in the IBD.

Animal Nutritional Physiological Phenomena↗
PubMed1996

Sphenoethmoidal mucoceles with intracranial extension--three case reports.

Three unusual cases of sphenoethmoidal mucoceles with rare intracranial extension are reported. A 64-year-old female presented with a 7-month history of right visual disturbance. Computed tomography (CT) and magnetic resonance (MR) imaging demonstrated a huge mass in the right middle fossa. She underwent right frontotemporal craniotomy. Postoperatively, her proptosis and cranial nerve dysfunction had improved markedly. A 53-year-old female complained of headache, nausea, and dizziness. CT and MR imaging revealed a cystic mass filling the right sphenoid sinus. The cystic lesion was evacuated through the transnasal approach. She was doing well postoperatively and has been asymptomatic. A 39-year-old male complained of headache, vomiting, and right visual disturbance. CT and MR imaging demonstrated a homogeneous mass occupying the sphenoid sinus. Sphenoidotomy exposed the cyst extending superiorly into the anterior cranial fossa. He recovered from the visual disturbances and has been asymptomatic since. MR imaging provides confirmation of the diagnosis of sphenoethmoidal mucocele and is important for preoperative evaluation.

Adult↗
PubMed1996

Improvement of renal function with a selective thromboxane A2 synthetase inhibitor, DP-1904, in lupus nephritis.

OBJECTIVE: To examine abnormalities of prostanoid metabolism in lupus nephritis, which may affect renal function, and the effects of 4 day dosing of a selective thromboxane A2 (TXA2) synthetase inhibitor, DP-1904, on prostanoid metabolism. METHODS: Urinary levels of various prostanoids, thromboxane B2(TXB2), 11-dehydro-TXB2, 6-keto-prostaglandin F1 alpha, 2,3-dinor-6-keto-PGF1 alpha, and prostaglandin E2 were determined. In a randomized crossover study, 8 patients with biopsy proven lupus nephritis were given 4 days' oral administration of DP-1904 (400 mg/day bid) or indomethacin (50 mg/day bid). The effects of DP-1904 on prostanoid metabolism were studied. RESULTS: Urinary excretion of TXB2, which reflects the renal production of TXA2, was significantly increased in patients with lupus nephritis compared with non-renal systemic lupus erythematosus (SLE)(p < 0.05); enhanced production of TXA2 was also estimated in patients with lupus nephritis. The urinary TXB2/6-keto-PGF1 alpha ratio was also increased in lupus nephritis compared with non-renal SLE (p < 0.01), indicating a prostanoid imbalance that may lead to impaired renal function and subsequent pathology. During administration of DP-1904, the urinary excretion of TXB2 was significantly decreased after 1 to 2 days. An increase in creatinine clearance as a measure of renal function was observed. In contrast, during the administration of indomethacin, urinary excretion of both TXB2 and 6-keto-PGF1 alpha decreased and there were no significant changes in the urinary TXB2/6-keto-PGF1 alpha ratio or creatinine clearance. Hemodynamic changes were associated with a slight increase in sodium excretion, but with no change in arterial blood pressure. No side effects were elicited during the 4 days of treatments. CONCLUSION: The abnormal prostanoid metabolism observed in lupus nephritis could aggravate renal function, which was mediated hemodynamically, and the altered metabolism was reversible and at least partially corrected by a TXA2 synthetase inhibitor, DP-1904.

Adult↗
PubMed1996

Successful treatment with cyclosporin A of pure red cell aplasia associated with rheumatoid arthritis.

We describe the first report of a patient with rheumatoid arthritis (RA) who developed refractory pure red cell aplasia that was successfully treated with cyclosporin A (CyA). Since no inhibitory activity against bone marrow was observed in the whole serum, it is possible that the clinical efficacy of CyA on both RA and aplasia was explained by its effects on T cells that might be involved in the development of these diseases.

Arthritis, Rheumatoid↗
PubMed1996

[Establishment of an estrogen receptor positive 3'-methyl-4-dimethylaminoazobenzene induced hepatoma cell line of rat and investigation of hormonal therapy].

An estrogen receptor (ER) positive cell line was newly established from a Wistar King Aptekman (WKA) rat, 3'-methyl-4-dimethylaminoazobenzene (DAB) induced hepatoma cell lines. The impact of hormonal therapy on cell growth was investigated. This cell line produced alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA) and ferritin in the conditioned medium. Progesterone receptors (PgR) were positive but androgen receptors (AR) were not detected. This cell line's doubling time was about 10.5 hours in a routine medium and 12.2 hours in the endogenous estrogen removed medium (exponential phase). The morphological features of the cell were of a hepatocellular type as observed by light microscopy. The modal chromosome number was 56 and the DNA ploidy pattern was aneuploid as observed by flow cytometry. The addition of 17 beta-estradiol (E2) did not increase cell growth but tamoxifen (TAM) in vitro inhibited cell growth in the lag phase. Surgical castration or oral administration of E2 or TAM in vivo inhibited tumor growth in the early phase. There were no additional effects between surgical castration and the administration of E2. Surgical castration plus the administration of TAM were not effective when combined. The administration of TAM caused the physiological effect of castration eg., diminished blood testosterone level same as E2 administration. TAM also decreased the maximal binding capacity (Bmax) of ER. A morphological change to the cholangiocell carcinoma type was noticed. These results that this cell line was ER dependent in the early phase of tumor growth.

Animals↗
PubMed1996

[Case of MPO-ANCA positive interstitial pneumonitis and necrotizing, crescentic glomerulonephritis].

A 52-year-old man was admitted to our hospital in July 1995, because of intermittent claudication, paresthesia on foot and gross hematuria. Chest radiograph in 1988 revealed bilateral interstitial shadows and proteinuria had been pointed out since 1992. On admission, chest X-ray and computed tomography showed diffuse interstitial shadow, however it had not been changed for several years. Laboratory tests revealed elevated level of erythrocyte sedimentation rate, C-reactive protein, immunoglobulin, rheumatoid factor, IgG-rheumatoid factor, and immune complex. Serum MPO-ANCA were positive. Although serum creatinine level and renal function test were normal, renal biopsy demonstrated crescentic formation and necrotizing vasculitis. Immunofluorescence and electron microscopy demonstrated no remarkable deposit in glomerulus. A diagnosis of microscopic polyarteritis necrotizing and crescentic glomerulonephritis (NCGN) was made. Treatment was initiated with 30 mg of prednisolone, followed by marked improvement of intermittent claudication, and decreased titer of serum MPO-ANCA. Previous reports have demonstrated the association of MPO-ANCA with rapidly progressive NCGN, microscopic polyarteritis, and occasionally pulmonary hemorrhage recognized as pulmonary-renal syndrome. However, the present case suggests the possibility that another disease subset may also be associated with MPO-ANCA, which is characterized by interstitial pneumonitis and slowly progressive glomerulonephritis.

Antibodies, Antineutrophil Cytoplasmic↗
PubMed1995

Heterotopic gastric mucosa of the gallbladder.

A case of heterotopic gastric mucosa in the fundus of the gallbladder is reported. A 23-year-old man, who had been healthy and asymptomatic, visited our hospital because of abnormal findings in a liver enzyme test given during a routine health screening. Ultrasonography demonstrated a highly echogenic polypoid mass in the fundus of the gallbladder. The gallbladder mass was confirmed by both computed tomography and intravenous cholangiogram. After a 10-month follow up, laparoscopic cholecystectomy was performed. Intraoperative touch smear cytology of this lesion revealed class II cells. The surgical specimen revealed a 15 x 10 x 5 mm polypoid lesion in the fundus, with no gallstones in the gallbladder. Histologically, the polypoid lesion consisted of both fundic type and pyloric type gastric glands located in the mucosa of the gallbladder. In the literature, 42 cases of heterotopic gastric mucosa of the gallbladder have been reported, only 3 of which, including this present case, were found incidentally, with no apparent symptoms.

Adult↗
PubMed1995

Adenomyoma of the common hepatic duct.

A very rare case of adenomyoma of the common hepatic duct is described. A 54-year-old woman was admitted with impending obstructive jaundice secondary to adenomyoma of the common hepatic duct. Our impression, formulated from her clinical presentation, endoscopic investigations, and biochemical and radiological findings, was a cancer of the proximal common hepatic duct. The patient was treated successfully by combination surgical resection and hepaticojejunostomy. Despite our obtaining an intraoperative frozen section, final histological examination was required to confirm the diagnosis. The patient remains well 16 months postoperatively. A survey of the world literature revealed that this is the second report of adenomyoma occurring in the common hepatic duct.

Adenomyoma↗
PubMed1995

[Methotrexate and salazosulfapyridine in the long-term treatment of rheumatoid arthritis].

Long term treatment of 190 cases of rheumatoid arthritis with either methotrexate or salazosulfapyridine was analyzed for their efficacy and adverse effects. Both treatment groups showed improvement of clinical symptoms, erythrocyte sedimentation rate, and CRP after 1 month of treatment, while RAHA titers decreased significantly after several months. Erythrocyte sedimentation rate and CRP of salazo-sulfapyridine group, once improved, deteriorated again after 12 months of treatment, while methotrexate group showed sustained improvement for 48 months. Radiologic progression estimated according to JF Fries was significantly less in MTX group than in SASP group. Life table analysis showed that the overall probability of continuing methotrexate or salazosulfapyridine at 4 years was 63% and 55%, respectively. The main reason of treatment termination in methotrexate group was adverse effects, while that in salazo-sulfapyridine group was inefficacy.

Adult↗
PubMed1993

Ammonia potentiates GABAA response in dissociated rat cortical neurons.

The ammonium ion (NH4+) evoked no response itself but facilitated the GABA-induced Cl- current (ICl) in dissociated rat cortical neurons. The GABA concentration-response curve shifted parallely to the left without changing the maximum response. Reversal potential of GABA response did not change in the presence of NH4+ at the concentration range between 0.1 and 1 mM. Ro 15-1788, a selective benzodiazepine receptor antagonist, did not affect the facilitatory action of NH4+ on GABAA receptor. The results suggest that NH4+ modifies the affinity of GABAA receptor for GABA, without the involvement of benzodiazepine receptors.

Ammonia↗
PubMed1993

Ultrasound imaging for stereotactic evacuation of hypertension-associated intracerebral hematomas with aqua-stream and aspiration.

Stereotactic aqua-stream and aspiration (SASA) has been used for the evacuation of intracerebral hematomas. The authors have introduced ultrasound imaging (US) to monitor the evacuations of the hematoma during the surgical procedure. Hematomas were reproduced in an agar hematoma model which showed that if air collected in the hematoma cavity, it produced a strong artifact, and the hematoma could not be monitored. In the clinical trial, hematomas were visualized, and the surgical procedures were monitored in real time. The needle of the SASA and the air that collected in the hematoma cavity produced only weak artifacts, and the SASA water jet showed as a hyperechoic region on US, so that the procedure could be monitored in real time. In all cases, the average amount of evacuated hematoma exceeded 92%, as calculated from the preoperative and postoperative computed tomography images. The level of consciousness improved from a preoperative level of 1-20 (Japan Coma Scale) to 0-3 postoperatively. The addition of US monitoring to computed tomography guided stereotactic evacuation of hematomas with SASA enabled hypertension-associated intracranial hematomas to be evacuated more safely and more completely than has been achieved hitherto.

Agar↗
PubMed1993

Non-specific immunological abnormalities and association of autoimmune diseases in idiopathic portal hypertension. A study by questionnaire.

A large survey by questionnaire of idiopathic portal hypertension (IPH) in Japan disclosed that 11.9% of 160 cases were associated with one or two autoimmune diseases, and 26.3% of them disclosed hypergammaglobulinemia. Patients with IPH also frequently showed one or more autoantibodies in the serum, such as antinuclear or anti-smooth muscle antibodies. These findings overlapped frequently in the same patient. These data imply that immunological disturbance and/or chronic antigenic stimulation are related to the pathogenesis of IPH, though the exact immunological mechanisms remain unclear. It will be necessary to study more specific immunological reactions in IPH.

Autoantibodies↗