[Visiting nursing service: organization and services of Wakabashi Visiting Nursing Station].
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Community Health Nursing↗
Biomedical subjects
H Katoh
Publications and source records attributed to H Katoh.
[Renal plasmacytoma].
Extramedullary plasmacytoma arising in the kidney is uncommon. So far only 11 cases have been reported. Recently, we noted the 12th case, the third case seen at the Kyoto University Hospital. The literature is reviewed. A 43-year-old man was hospitalized because of paraplegia due to spinal cord compression by the solitary plasmacytoma arising in the cervical spine, producing an IgG-lambda paraprotein. The tumor excision was followed by radiotherapy and standard chemotherapy. Two years later, new lesions on the thoracic spine, the left clavicle, and the occipital bone successively developed with Bence Jones proteinuria (lambda), but without IgG-lambda paraproteinemia. Ga-67 scanning was performed to detect extramedullary tumors. The marked accumulation of the radionuclide revealed intraabdominal tumors. A CT scan of the abdomen revealed a large soft-tissue mass (73 x 50 mm) emanating from the right kidney and several enlarged lymph nodes. Ultrasound of the right kidney revealed a solid mass with hydronephrotic change. RI-renogram showed delayed excretion from the right kidney. Clusters of myeloma cells were repeatedly observed in the urinary sediment. Thus, a diagnosis of plasmacytoma of the kidney was made. Treatment with radiotherapy alone was sufficient.
Adult↗
Concentrations of cytokines in peritoneal fluid after abdominal surgery.
OBJECTIVE: To assess the role of concentrations of cytokines in peritoneal fluid in estimating the severity of the host's response to the stress of abdominal operations. DESIGN: Prospective study. SETTING: University hospital, Japan. SUBJECT: 49 patients who underwent various abdominal operations. Main outcome measures--Correlations between concentrations of tumor necrosis factor-alpha (TNF-alpha), interleukin-1 beta (IL-1 beta), and interleukin-6 (IL-6) in peritoneal fluid measured on the first postoperative day on the one hand, and peritoneal bacterial count, length of operation, and operative blood loss, on the other. RESULTS: The concentrations of all three peritoneal cytokines correlated significantly with length of operation; those of TNF-alpha and IL-1 beta also correlated significantly with peritoneal bacterial count, and that of IL-1 beta with operative blood loss. There were significant correlations between the concentrations of the three cytokines. CONCLUSION: These correlations suggest that monitoring of the peritoneal concentrations of TNF-alpha, IL-1 beta, and IL-6 may be helpful in estimating the severity of stress caused by abdominal operations.
Abdomen↗
[Effects of high doses of beclomethasone dipropionate in bronchial asthma].
To evaluate the clinical efficacy of high dose inhaled steroids, we examined the effects of standard doses (400 micrograms/day) and high doses (800 micrograms/day) of inhaled beclomethasone dipropionate (BDP, Becotide Inhaler), and the dose for regular use (800 micrograms/day) of salbutamol (Salb. Asmidon Air) on pulmonary function, bronchial hyperresponsiveness and asthma attack score. The subjects were 17 out-patients with mild or moderate bronchial asthma who were not receiving any anti-allergics or steroids. The patients were randomly allocated into three groups i.e., Group I: BDP 400 micrograms/day, Group II: BDP 800 micrograms/day and Group III: Salb. 800 micrograms/day. The administration period was 8 weeks. Pulmonary function test were performed and bronchial hyperresponsiveness was examined before and after the 8 weeks of treatment and attack scores were recorded during this period. It was found that inhalations of 400 micrograms/day and 800 micrograms/day BDP improved FEV1.0% value, peak flow, F-V curve, Dmin. and SGrs/Grs cont. Particularly, inhalation of 800 micrograms/day of BDP significantly improved these values and reduced attack scores in the early stages of the 8 week treatment. In contrast, there was a trend for inhalation of Salbutamol to enhance bronchial hyperresponsiveness and not to improve pulmonary function and asthma attack score. In conclusion, 800 micrograms/day of inhaled BDP is considered to be useful in the treatment of mild or moderate bronchial asthma.
Adult↗
[Effects of prostaglandin E1 on temperature gradients between hand and foot during epidural anesthesia].
We studied the effects of prostaglandin E1 (PGE1) on hand-foot temperature gradients (foot temperature-hand temperature) induced by lumbar epidural anesthesia. Thirty-six ASA class 1 patients undergoing rotatory acetabular osteotomy were randomly assigned to receive 0 gamma (n = 13), 0.005 gamma (n = 10) and 0.02 gamma (n = 13) of PGE1. Thermometric probes were placed on the palm and sole of each patient. Bladder temperature was also monitored to evaluate the change of core temperature. Epidural catheter was indwelled at the level between L2 and L3 prior to induction and 2 % lidocaine was administered epidurally. All patients were warmed by water blanket at 37 degrees C and fluids for infusion warmed at 37 degrees C. Humidity and moisture exchanger was placed in breathing circuit. Hand-foot temperature gradients of patients given 0 and 0.005 gamma of PGE1 increased to 2.8 +/- 1.5 and 2.3 +/- 2.3 degrees C at extubation, respectively. In contrast, temperature gradient of patients given 0.02 gamma of PGE1 was 0.0 +/- 1.8 degrees C (P < 0.01). There was no difference among the values of bladder temperature in each group. The effects of PGE1 on mean arterial pressure, heart rate and central venous pressure were minimal. These data suggest that 0.02 gamma of PGE1 administration is effective to reduce hand-foot temperature gradient during epidural anesthesia.
Adult↗
[Usefulness anti-PPD antibody in the medical practice of tuberculosis].
The decline rate of tuberculosis has decreased recently in Japan. One of the problems is the tendency of increasing doctor's delay in the diagnosis of tuberculosis. One of measures against this problem is to develop a new laboratory diagnostic method. We studied anti-PPD (Purified Protein Derivative of tuberculin) antibody in serum, pleural effusion, and bronchoalveolar lavage fluid (BAL), and found its clinical usefulness in the medical practice of tuberculosis. Firstly the methods of enzyme linked immunosorbent assay (ELISA) for the antibody to PPD were examined. The expression of antibody titer in optical density was found to be the most accurate and most simple method, and was applied in this study. IgG, IgM and IgA antibody to PPD were measured in serum, BAL and pleural effusion obtained from 122 patients with pulmonary tuberculosis, 54 patients with tuberculous pleurisy, 39 patients with lung cancer, 39 patients with malignant pleurisy, 37 patients with pneumonia, 26 patients with chronic bronchitis, 51 patients with sarcoidosis, or 49 control subjects. Serum level of IgG, IgM, and IgA antibody to PPD was elevated in tuberculosis compared with those in other diseases or control subjects. The difference was most distinctive in IgG antibody. Serum IgG antibody was higher in chronic case than in acute case and IgM antibody was higher in acute case than in chronic case. IgG, IgM and IgA antibody in pleural effusion was elevated in tuberculous pleurisy compared with those in malignant pleurisy. IgG antibody was higher in chronic tuberculous pleurisy than in acute tuberculous pleurisy and IgM antibody was higher in acute pleurisy than in chronic one.(ABSTRACT TRUNCATED AT 250 WORDS)
Antibodies, Bacterial↗
[Planned production of poliovirus-sensitive transgenic mice].
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Animal Husbandry↗
[Effect of combined spinal and epidural anesthesia on blood loss during total hip replacement].
Ninety total hip replacements (THRs) performed by one surgeon were reviewed to compare the effects of different anesthetic techniques on the perioperative bleeding. Half of the THRs were performed under either combined spinal and epidural (CSE) anesthesia with lidocaine or general anesthesia with N2O/O2, vecuronium, enflurane or isoflurane. Deliberate hypotensive technique was not employed in any THR. All patients were female and had suffered from osteoarthritis of the hip joints. The patients in the two anesthesia groups were similar as to age, body weight, height, perioperative hemoglobin level, duration of anesthesia and operation, and blood transfusion requirement. A positive linear correlation existed between total operative blood loss and operation time in each group (P < 0.01). The rate of operative blood loss was significantly higher in the CSE anesthesia (6.2 +/- 3.0 ml.min-1) than in the general anesthesia (5.1 +/- 2.0 ml.min-1), while the amount of blood loss itself was without statistical difference. A significant increase in total volume of perioperative blood loss was also observed in the group with CSE anesthesia (1520 +/- 90 ml) compared with the general anesthesia group (1279 +/- 58 ml). These results show that spinal and/or epidural anesthesia can not always lead to reductions in operative blood loss during THR.
Aged↗
[Effects of prostaglandin E1 on renal function during deliberate hypotension with epidural anesthesia].
We studied the effects of prostaglandin E1 (PGE1) on renal function during and after deliberate hypotension induced by epidural anesthesia. Twenty-seven ASA class 1 patients undergoing rotatory acetabular osteotomy were divided into three groups according to the dose of PGE1. Deliberate hypotension was induced and maintained during the surgery by epidural anesthesia combined with general anesthesia. PGE1 increased urine output and creatinine clearance (Ccr) during hypotension in dose dependent manner, and the changes were statistically significant compared with control at the dose of 0.02 micrograms.kg-1 x min-1 (gamma). PGE1 also tended to increase postoperative urine output and Ccr. Regardless of PGE1 administration, urine NAG/Cr ratio tended to increase during and after deliberate hypotension. Though total dose of local anesthetics was attenuated by PGE1, serum catecholamine levels of all patients were within normal ranges. In conclusion, PGE1 0.02 gamma is effective to maintain urine output during deliberate hypotension with epidural anesthesia. However, PGE1 is unlikely to prevent renal tubular damage at the dose less than 0.02 gamma.
Acetabulum↗
[A better method to attach an endotracheal tube to the stylet of the Bullard laryngoscope].
The Bullard laryngoscope with its introducing stylet is useful in a variety of patients with airway problems, but it poses difficulties in some cases where an endotracheal tube (ETT) catches on the ary-epiglottic fold and cannot be advanced into the trachea. This difficult may be avoided by slightly angulating the tip of the ETT so that it is directed in a better alignment toward the rima glottis. The efficacy of the two methods of angulation was studied. One hundred and eight patients were randomly assigned to one of three groups. In group 1 (control, 36 patients), the ETT was attached naturally to the stylet with the bevel facing left. In group 2 (36 patients), the ETT was hooked on the distal end of the stylet at the Murphy eye, as recommended by the manufacturer. In group 3 (36 patients), the ETT was set over the stylet after being rotated 180 degrees so that the bevel was directed to the right. Intubation on the first attempt was successful in 56% of group 1, 83% in group 2 and 100% in group 3. The patients in groups 1 & 2 in whom first attempt failed were all successfully intubated on the second trial with the method used in group 3. This method (180 degrees rotation of the ETT on the stylet), is applicable to any ETT with or without the Murphy eye.
Adolescent↗
[Clinical application of 99mTc-DTPA-galactosyl serum albumin in hepatobiliary disease].
A clinical study with 99mTc-DTPA-galactosyl serum albumin (99mTc-GSA) was performed in 10 patients with hepatobiliary disease. In this study, scintigraphic data and images with 99mTc-GSA were compared with several serological liver function tests, the hepatic blood perfusion index and image quality using 99mTc-DTPA-human serum albumin (99mTc-HSA). Dynamic and serial hepatic images were obtained over a 20 min period after 99mTc-GSA injection, and time activity curves from the heart and liver were generated. The blood clearance index (HH15), and the hepatic uptake index (LHL15) were calculated from each curve of the heart and liver, respectively. In addition, using two compartment fitting, the blood clearance (KH1, KH2) index was calculated, and using exponential fitting, the hepatic uptake index (KL) was calculated. The mean HH15 in LC group and non-LC group was 0.81 +/- 0.05, 0.64 +/- 0.10, respectively. The mean LHL15 in LC group and non-LC group was 0.79 +/- 0.04, 0.91 +/- 0.06, respectively. There were significant differences between non-LC group and LC group in HH15, and LHL15, KH1 and KL. There were also significant correlations of KH1 with HH15, and KL with LHL15. Parameters of 99mTc-GSA showed significant correlations with various liver functions. 99mTc-GSA scintigraphy showed clearer liver images in hepatobiliary diseases than 99mTc-HSA. These results suggest that 99mTc-GSA scintigraphy is useful in estimating preserved liver function and hepatic morphology.
Adult↗
Mortality rate and bacteremia, endotoxin, and endothelin-1 levels in antibiotic therapy for E. coli septic peritonitis.
In order to study the mortality rate and bacteremia, plasma endotoxin, and plasma endothelin-1 levels in antibiotic therapy for E. coli peritonitis, blood samples were obtained from rats given intraperitoneal injections of latamoxef or placebo. Intraperitoneal injections of latamoxef improved the prognosis of peritonitis rats. Two h after treatment, bacteremia levels were noticeably higher in rats treated with placebo than in rats treated with latamoxef, but the latamoxef-treated group manifested a significant elevation of plasma endotoxin and endothelin-1 levels compared to the placebo-treated group. The results of this study demonstrate that treating E. coli septic peritonitis with selected antibiotics induces increased plasma endotoxin levels, which are associated with elevation of plasma endothelin-1 levels.
Animals↗
[Optimal glucose dose in the preoperative fluid infusion].
We have measured blood concentrations of glucose, 3-hydroxybutyrate (3-OHBA), non-esterified fatty acid (NEFA) and lactate before and after glucose administration in 105 patients to determine the optimal glucose dose during the period of preoperative fasting state. The patients, scheduled for laparotomy in the afternoon, received fluid infusion containing an arbitrary glucose dose for 4 hours prior to surgery. The glucose dose showed a negative correlation with the ratio of 3-OHBA or NEFA prior to and after glucose administration (r = 0.40, r = 0.41 respectively, P < 0.05). There was no correlation between lactate ratio and glucose dose (r = 0.06). Glucose administration more than 0.4 g.kg-1 significantly suppressed 3-OHBA production (P < 0.05). Hyperglycemia (> 200 mg.dl-1) developed more often in the groups given 0.5 g.kg-1 or more glucose (P < 0.05), while significant hypoglycemia (< 60 mg.dl-1) occurred in the groups given less than 0.2 g.kg-1 of glucose (P < 0.05). This study demonstrates that preoperative infusion of glucose 0.4-0.5 g.kg-1 is useful to maintain the energy metabolism during the fasting state in patients scheduled for operation in the afternoon.
Adult↗
Correlation of myc expression with the growth-arrested and transformed phenotypes in hybrids between a T lymphoma and an antigen-responsive T-cell line.
Fusion of the YACUT lymphoma cell line with the Mls-1a-antigen-specific non-tumorigenic T-cell line G4 produced growth-arrested hybrids that could be induced to proliferate in the presence of Mls-1a antigen. Prolonged growth of such hybrids by repeated antigenic stimulation resulted in the appearance of autonomously growing hybrid lines. Of the 4 antigen-independent hybrid clones, I was weakly tumorigenic (25% incidence) while the other 3 were highly tumorigenic (100% incidence). In the growth-arrested hybrids the de-regulated c-myc expression characteristic of the YACUT cells was suppressed. In the autonomously growing clones, however, c-myc expression had reverted to the levels of the lymphoma parent and 1 to 2 extra copies of chromosome 15 were consistently present. These results indicate that repeated antigenic stimulation somehow abrogated the down-regulation of c-myc in the growth-arrested hybrid lines. The increase in the number of copies of chromosome 15, however, suggests that genes located on this chromosome may abolish the effect of the negative regulatory functions of the non-malignant parent in a gene-dosage-dependent manner.
Animals↗
Prostaglandin E1 enhances hepatic portal venous flow by dilating the portal vascular bed in 70% hepatectomized dog.
The effects of portal, hepatic arterial and femoral venous administration of prostaglandin E1 (PGE) on portal venous flow (PVF) and hepatic arterial flow HAF were examined before and after 70% hepatectomy in anesthetized dogs. In the hepatectomized condition, portal venous administration of PGE (0.5 microgram/kg/min) caused an increase in PVF without any change in systemic arterial pressure (SAP). HAF was unchanged following the injection. The portal effect of PGE on PVF was dose-dependent, and a reduction in portal venous resistance was seen. However, the same dose of PGE failed to change PVF under intact liver conditions. Hepatic arterial administration of PGE (0.5 microgram/kg/min) brought no significant change in PVF or HAF, with or without hepatectomy. Femoral venous administration of PGE (0.5 micrograms/kg/min) produced an increase in PVF concomitant with a significant decrease in SAP. HAF showed no change after the injection. A decrease in PVR was seen only in the hepatectomized condition. It is concluded that PGE is potent in increasing PVF in the hepatectomized condition, and the portal vasculature is involved as the site of action.
Alprostadil↗
Analysis of lectin properties with membrane ultrafiltration and high-pressure liquid chromatography.
A convenient method for the analysis of the binding properties of lectin with fluorogenic sugar chains is described. A lectin (concanavalin A or Datura stramonium agglutinin) was mixed with pyridylaminated sugar chains in buffer and the free chains obtained were isolated by membrane ultrafiltration. The amount of free sugar chains in the filtrate was measured by high-pressure liquid chromatography. The binding constants with the sugar chains, reaction kinetics, and other properties of these lectins were easily investigated. The method is simple and could be used to study the characteristics of any lectin in native form.
Binding Sites↗
Airway management with a special tube in an infant with bronchial obstruction.
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Aortic Diseases↗
Coagulopathy in disseminated intravascular coagulation due to abdominal sepsis: determination of prothrombin fragment 1 + 2 and other markers.
To estimate the degree of coagulopathy in abdominal sepsis, we measured the plasma levels of prothrombin fragment 1 + 2 (F1 + 2), thrombin-antithrombin III complex (TAT) and plasmin-alpha 2-plasmin inhibitor complex (PIC) by the enzyme-linked immunosorbent assay in 38 patients with disseminated intravascular coagulation (DIC). In 20 patients with DIC due to abdominal sepsis, plasma levels of F1 + 2, TAT and PIC were 2.6 nmol/l, 27.9 micrograms/l and 1.5 micrograms/ml, respectively, with a mean antithrombin III (AT III) activity of 41.7%. F1 + 2, TAT, PIC and AT III levels were 4.7 nmol/l, 75.8 micrograms/l, 8.8 micrograms/ml and 70.9% in 18 patients with DIC as the result of malignancy. Though AT III levels in DIC due to sepsis were lower than those in DIC due to malignancy, the levels of F1 + 2, TAT and PIC in the former were not significantly more increased than those in the latter. The plasma levels of F1 + 2 were positively correlated with TAT and PIC in DIC patients with malignancy; however, there was no correlation between F1 + 2 and TAT or PIC in DIC patients with sepsis. In addition, the levels of serum albumin in the two groups were similar. These results suggest that activation of coagulation and fibrinolytic systems may not be so prominent in cases of DIC due to abdominal sepsis, compared to related events in DIC due to malignancy. It is also suggested that the depletion of AT III in cases of sepsis is not only caused by a consumption related to intravascular coagulation or to an alternate distribution of protein.(ABSTRACT TRUNCATED AT 250 WORDS)
Antifibrinolytic Agents↗