Biomedical subjects

H Koga

Publications and source records attributed to H Koga.

At least 235 records · Page 13Linked to original sources

PubMed1994

Effects of diet on experimentally induced intestinal ulcers in rats: morphology and tissue leukotrienes.

The effects of dietary pretreatment on longitudinal ulcers of the intestine induced by indomethacin given intracolonically were investigated in rats. The rats were pretreated with either standard diet or liquid meals. Intracolonic indomethacin (24 mg/kg/day) given for two days produced longitudinal ulcers and small scattered ulcers in the small intestine in the control rats that were receiving standard pelleted formula. Three days pretreatment with one of two types of liquid meals, low residual diet (LRD) or elemental diet (ED), significantly reduced the incidence (3% in ED group and 0% in the LRD group) and the length of the longitudinal ulcers in the small intestine. The caecum was affected in each dietary pretreatment group (67% in controls, 80% in LRD group, and 69% in ED group). Colonic ulcers that were located in a longitudinal fashion were found in 42% of LRD group, while these ulcers were less frequently found in the ED group (13%) and controls (0%). Development of ulcers in the caecum and in the colon of rats in ED and LRD groups was more delayed than that of small intestinal ulcers of control rats. In another experiment, pretreatment by ED significantly increased colonic tissue leukotriene B4 concentration when compared with that of controls. These findings suggest that the site of experimental enteropathy induced by indomethacin given intracolonically can be modified by dietary pretreatment. This animal model can be available for investigating differences in the pathophysiology of enteropathy according to the site of involvement.

Animals↗

PubMed1994

Early advanced hepatocellular carcinoma: evaluation of CT and MR appearance with pathologic correlation.

PURPOSE: To determine the computed tomographic (CT) and magnetic resonance (MR) imaging appearances of early advanced hepatocellular carcinoma (HCC). MATERIALS AND METHODS: Twenty-seven surgically resected cases of early advanced HCC were studied with CT, CT during arterial portography, CT arteriography, and MR imaging. RESULTS: The sensitivity of standard CT (unenhanced, early, and late CT combined) for the detection of early advanced HCC was 81%, while that of standard MR imaging (T1- and T2-weighted MR imaging combined) was 83%. A nodule-in-nodule appearance was identified in approximately one-third to one-half of cases. Signal behavior of early and advanced components of early advanced HCC followed the expected behaviors of isolated early HCC and isolated advanced HCC, respectively. Tumor size was accurately estimated with standard CT and standard MR imaging. CONCLUSION: More research must be performed to ascertain whether any relationship exists between the different types of HCC and the clinical outcome.

Aged↗

PubMed1994

Proliferating cell nuclear antigen in needle biopsy specimens of prostatic carcinoma.

The expression of proliferating cell nuclear antigen (PCNA) was immunohistochemically determined using a monoclonal antibody PC10 in 54 prostatic carcinoma samples. The samples were taken from needle biopsy specimens which had been paraffin-embedded after routine fixation with 10% formaldehyde solution (formalin) for less than 24 h. The PCNA index was calculated as the percentage of positive tumor cell nuclei. There was a significant difference in the PCNA index according to the growth pattern (p < 0.001), nuclear anaplasia (p < 0.001) and T stage (p < 0.01). Regarding the growth pattern, solid carcinomas showed a significantly higher PCNA index than did either separate gland carcinomas (p < 0.05) or trabecular/fused gland carcinomas (p < 0.05). The PCNA index correlated closely with either the nuclear anaplasia or T stage, and increased in conjunction with the increased nuclear anaplasia (rs = 0.641; p < 0.001) or T stage (rs = 0.435; p < 0.01). The patients in the high PCNA index (> or = 15%) group showed a significantly worse survival than did those in the lower PCNA index group (p < 0.01), and multivariate analyses indicated that the PCNA index had an independent prognostic significance. These results suggest that the PCNA index, as determined by PC 10 on needle biopsy specimens of prostatic carcinoma, can thus be an objective and quantitative means for evaluating the biological malignancy of prostatic carcinoma.

Adenocarcinoma↗

PubMed1994

Re-evaluation of bone marrow aspiration in the diagnosis of miliary tuberculosis.

We studied eight patients with miliary tuberculosis (TB). In all instances, tuberculomatous lesions were demonstrated in the aspirated bone marrow. We conclude that the bone marrow aspiration has great value in diagnosing miliary TB because it provides sufficient material to permit examination of serial sections as needed to confirm the diagnosis. The bone marrow aspiration also is safer than the alternative procedures of lung or liver biopsies.

Adult↗

PubMed1994

The pattern of respiratory infection in patients with lung cancer.

We examined retrospectively the pattern of respiratory infection in 579 patients with lung cancer admitted to Nagasaki University Hospital during the past 15 years. A total of 139 patients (24.0%) developed respiratory infection. The rates of pulmonary infection associated with large (36.2%) and small cell carcinomas (33.6%) were significantly higher than those with squamous cell carcinoma (26.0%) and adenocarcinoma (17.3%). Advanced stages of lung cancer were associated with higher complication rates (stage I: 6.3%, stage II: 15.9%, stage III: 27.9%, and stage IV: 33.8%). Deceased patients showed a significantly higher rate of pulmonary infection than alive patients during the period of investigation. Isolated organisms in excess of 10(7) cfu/ml in sputum or 10(4) cfu/ml in bronchial aspirate were mainly gram-negative bacteria (68.8%), such as Haemophilus influenzae, Klebsiella pneumoniae, Enterobacter cloacae, Acinetobacter sp. and Pseudomonas aeruginosa. The number of patients infected with gram-positive bacteria increased markedly after 1982. Our results suggest that a successful control of pulmonary infection associated with lung cancer is important in improving the prognosis of lung malignancy.

Adenoma↗

PubMed1994

Preliminary evaluation of the new tumor marker, CYFRA 21-1, in lung cancer patients.

Serum samples from 137 lung cancer patients were examined by RIA to evaluate the clinical efficacy of the new tumor marker, CYFRA 21-1, which could identify the soluble fragment of cytokeratin 19. The cut-off value was determined to be 2.2 ng/ml according to the receiver operating characteristic curve. The sensitivity, specificity and accuracy of the RIA for CYFRA 21-1 were 57.7, 91.9 and 64.9%, respectively. The serum concentration of CYFRA 21-1 and the sensitivity of the assay increased as the disease progressed. Histologically, the sensitivity was highest for squamous cell carcinomas (SQ) (76.5%) in comparison with adenocarcinomas (47.8%) and small cell lung cancers (42.1%) (P < 0.01, P < 0.05, respectively). The sensitivities for SQ were 60.0, 83.3, 80.0 and 100% at stages I, II, III and IV, respectively. When compared with CEA (45.3%) and squamous cell carcinoma related antigen (SCC) (22.6%) in all lung carcinomas, CYFRA 21-1 showed the highest sensitivity (57.7%), (P < 0.05, P < 0.01, respectively). In SQ, the sensitivity of the CYFRA 21-1 RIA was significantly higher than that of the assay for SCC (47.1%) (P < 0.05). In patients with adenocarcinomas, the sensitivity of the CYFRA 21-1 assay was almost the same as that for CEA (49.3%). In a combination of CYFRA 21-1 and CEA for non-small cell lung cancers (NSCLC), the sensitivity and accuracy increased to 75.4 and 78.1%, respectively, although the specificity decreased to 86.5%. It is concluded that CYFRA 21-1 could replace SCC, a less satisfactory tumor marker, for SQ of the lung. The potentiality of the combination of CYFRA 21-1 and CEA for NSCLC should be estimated using larger samples in the near future.

Adenocarcinoma↗

PubMed1994

[A case of pulmonary tuberculosis developed immediately after a chest wall injury].

A 75-year-old female was admitted to our hospital for further examination of the cause of blood-stained sputum and abnormal shadow on chest radiogram which had developed immediately after an injury of right chest wall. The bacteriological examination of sputum on admission revealed negative Gaffky score, but positive PCR, and Mycobacterium tuberculosis was isolated by culture. Her symptoms and chest radiogram were improved by the administration of isoniazid, ethambutol and rifampicin. Although development of pulmonary tuberculosis induced by chest wall injury is rare, in case of the aged persons such possibility should be considered. PCR may be useful for rapid diagnosis of tuberculosis, even in such case.

Aged↗

PubMed1994

[Clinical studies on the time-difference combination therapy with netilmicin and minocycline in methicillin-resistant Staphylococcus aureus infections].

Twenty-eight patients with methicillin-resistant Staphylococcus aureus (MRSA) infections were clinically studied for the effectiveness of the time-difference combination use of netilmicin (NTL) and minocycline (MINO). The patients were treated with NTL 100 mg and two hours later, with MINO 100 mg intravenously, twice daily, in the morning and evening for 14 days. Of 26 patients, MRSA was eradicated in 16 (61.5%), decreased in one, and unchanged in nine. Superinfections occurred with Serratia marcescens and Pseudomonas aeruginosa in two patients. The clinical efficacies were assessed in two patients with septicemia, 16 with pneumonia, and eight with chronic bronchitis. The obtained results were excellent in four patients, good in 15, fair in six, and poor in one patient. The rate of effectiveness was 73.1% (19/26). The overall clinical effectiveness judged by the committee was good in 19, fair in five, and poor in two patients. The efficacy rate was also 73.1% (19/26). Coagulase type II of MRSA was found in 23 patients, and coagulase type III in three patients, with overall clinical efficacy rates of 73.9% (17/23) and 66.7% (2/3), respectively. A side effect of eruption was observed in one patient, and its incidence was 3.6% (1/28). Abnormal laboratory test results were observed in 16 patients (57.1%), including abnormal liver function in 14 patients, abnormal kidney function in three, and increased eosinophils in three. Laboratory abnormalities occurred twelve of 16 bedridden patients, and this rate was higher than that in non bedridden patients. However, these abnormalities were all mild, transient, and immediately recovered after the treatment. In conclusion, the time-difference combination therapy using NTL and MINO was effective in the treatment of MRSA infections.

Adolescent↗

PubMed1994

[A case of HTLV-1 carrier associated with pulmonary cryptococcosis and thymoma].

A 46-year-old female was admitted to our hospital on December 1991 for further examination of an abnormal shadow on chest X-ray. A huge mass in the upper mediastinum and a thin-walled cavitary lesion in the right upper lobe were found by chest radiography and computed tomography. On March 2, 1992, surgical resection was performed with pathological diagnosis of thymoma for the mediastinal mass and pulmonary cryptococcosis for the cavitary lesion. Although ATL cells were not found in the peripheral blood, anti-HTLV-1 antibody was found to be positive. Natural killer cell activity was lower than normal control and other tests of humoral and cell-mediated immunity were normal. Histological examination of the specimens obtained from the thymoma revealed lymphocytic predominance without atypical cells such as ATL cells, but with integration of HTLV-1 proviral DNA. There seemed to be a causal relationship between HTLV-1 carrier state and thymoma. Since there are no reported cases of HTLV-1 carrier associated with pulmonary cryptococcosis and thymoma, we report the first case with a review of the literature.

Carrier State↗

PubMed1994

[Cerebellopontine angle lipoma with vascular anomaly: a case report].

A case was reported of cerebellopontine angle lipoma with vascular anomaly which was thought to be the remnant of fetal anastomosis of the posterior inferior cerebellar artery (PICA) and of the anterior inferior cerebellar artery (AICA). A 42 year-old man had been suffering from intermittent dizziness for a year. Worsening of dizziness after mild head trauma led him to visit a doctor who pointed out a cerebellopontine angle lesion. On admission to our hospital, neurological examination revealed no deficit. Computerized tomography (CT) scanning showed a low density mass in the right cerebellopontine angle, which was 1.5cm in diameter and showed no enhancement with intravenous contrast material. The attenuation value on CT of this lesion was--101 Hounsfield units. MRI showed a homogeneous mass, which was markedly hyperintense on T1 weighted image and proton image, isointense with chemical shift artifact on T2 weighted image and markedly hypointense on short TI IR (STIR) image. Signal characteristics on MRI were consistent with those of lipoma. Interestingly, MRI demonstrated the cranial nerves and vessels penetrating small lesion. The vertebral angiograms revealed the anastomosis of PICA and AICA with segmentally hypoplastic vertebral artery on the right side and the dilatation of the right distal AICA. Through a right suboccipital approach a yellowish mass in the right cerebellopontine angle was resected partially (about 50%). Only partial resection was possible because of the bleeding from small arteries and the tight adhesion to cranial nerves and brain stem. Histological findings of the surgical specimen were consistent with those of a lipoma. Postoperative neurological examination showed no neurological deficit.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1994

[Rapid identification of mycobacteria by combined method of polymerase chain reaction and the gen-probe DNA hybridization system].

We developed the rapid detection and identification method of mycobacteria, involving amplification of mycobacterial 16S rRNA gene by nested PCR and identification of M. tuberculosis complex or M. avium-intracellulare complex (MAC) by hybridization protection assay (HPA) using the acridinium-ester (AE) labeled DNA probe. The specificity of the nested PCR combined with DNA probe test was excellent in terms of detection of mycobacterial organisms and identification of M. tuberculosis or MAC. The detection limits of the present method were 10 fg DNA for M. tuberculosis, and 100 fg DNA for MAC, respectively. We further investigated on the optimum temperature for hybridization in HPA with AE labeled DNA probe because there was the difference in the mode of DNA-RNA hybridization from that of DNA-DNA hybridization. In our method, the optimum temperature of hybridization was estimated as 55 +/- 1 degrees C. In preliminary experiments on two clinical cases, we practically detected and identified M. tuberculosis and MAC in clinical specimens, such as sputa, by using this newly devised method. We concluded that this method is useful for rapid detection and identification of M. tuberculosis and MAC in clinical specimens.

Adult↗

PubMed1994

[Evaluation for rapid detection of rifampicin-resistant mycobacterium tuberculosis by polymerase chain reaction-single strand conformation polymorphism].

We evaluated usefulness of the rapid diagnostic method for detection of rifampicin (RFP)-resistant Mycobacterium tuberculosis, which was based on polymerase chain reaction. The MICs of RFP were measured for 38 clinical isolates of Mycobacterium tuberculosis which were suspected to be RFP-resistant organisms, and 12 strains were found to be resistant to RFP. The PCR primers used were the same as those reported by Telenti et al, which were targeting the RNA polymerase beta subunit gene (rpoB). We confirmed that this gene was possessed by all the strains tested. Eight strains out of the 12 strains with RFP-resistant phenotype were demonstrated to have a point mutation or some alterationin the rpoB gene on the basis of PCR-single strand conformation polymorphism (SSCP). Thus, the sensitivity of our method was calculated as 67%. In addition, we could not detect any alterations in the rpoB gene by all RFP-susceptible strains. These results indicated that rapid detection of the RFP-resistant Mycobacterium tuberculosis was possible directly from clinical specimens by using PCR-SSCP technique.

Base Sequence↗

PubMed1994

Primary malignant lymphoma of the brain: demonstration of the p53 gene mutations by PCR-SSCP analysis and immunohistochemistry.

Using PCR-SSCP and immunohistochemical analyses, mutations of the p53 tumor suppressor gene were examined in 5 cases of primary malignant lymphoma of the brain (diffuse large cell type). By PCR-SSCP and nucleotide analyses, p53 gene mutations were seen in 2 of the 5 cases. The mutation in one case was a missense G: C-T:A transversion at codon 176 (TGC-TTC; Cys-Phe) which was located in the highly conserved domains and adjoined a previously proposed hot spot codon (codon 175) in various tumors. p53 immunoreactivity was also shown in this case. The mutation in another case was a nonsense G:C-A:T transition at codon 52 (TGG-TGA; Trp-stop codon) leading to a truncated p53 peptide. Thus, these mutations may have actually given rise to serious structural and functional alterations of the p53 protein. These findings suggested that the p53 gene mutation was related with oncogenesis in the primary malignant lymphoma of the brain.

Adult↗

PubMed1994

Effects of anti-allergy drugs on fMet-Leu-Phe-stimulated superoxide generation in human neutrophils.

We examined effects of six oral anti-allergy drugs used to treat bronchial asthma on fMet-Leu-Phe (N-formyl-methionyl-leucyl-phenylalanine)-induced superoxide (O2-) generation and mobilization of intracellular free calcium ([Ca2+]i) in human neutrophils. We also evaluated the direct action of these drugs on NADPH (reduced nicotinamide-adenine dinucleotide phosphate)-oxidase activity in cell lysate (cell-free system). Ketotifen (25 approximately 200 microM) enhanced fMet-Leu-Phe-stimulated O2- generation and [Ca2+]i mobilization, although it directly inhibited NADPH oxidase in the cell-free study. Low concentrations of oxatomide (5-20 microM) enhanced O2- generation, but concentrations > 25 microM inhibited O2- generation. In concentrations below 20 microM, oxatomide had no effects on fMet-Leu-Phe-stimulated [Ca2+]i mobilization, but at concentrations above 25 microM, it inhibited [Ca2+]i mobilization. Oxatomide inhibited NADPH oxidase activity at all concentrations examined. Azelastine, pemirolast, tranilast, and repirinast inhibited O2- generation and [Ca2+]i mobilization. Azelastine and pemirolast directly inhibited NADPH oxidase, but tranilast and repirinast did not. Our results indicated that except for ketotifen and low concentration of oxatomide, oral anti-allergy drugs used to treat bronchial asthma inhibited fMet-Leu-Phe-induced O2- generation in human neutrophils. Based on IC50 values, potency of drugs was as follows: oxatomide > azelastine > tranilast > pemirolast > repirinast.

Adult↗

PubMed1994

[Clinical trial of protocol-AL851 for children with high-risk acute lymphoblastic leukemia. Kyushu Yamaguchi Children's Cancer Study Group (KYCCSG)].

Fifty five children diagnosed as having high-risk acute lymphoblastic leukemia (ALL) between 1985 and 1988 were treated with protocol AL851. The agents used in the protocol were as follows: induction therapy: vincristine (VCR), prednisolone, daunorubicin (DNR) and l-asparaginase, consolidation therapy: an intermediate-dose methotrexate (MTX), central nervous system (CNS) leukemia prophylaxis: intrathecal MTX and 24Gy cranial irradiation, reinduction therapy: VCR, adriamycin, dexamethasone and high dose cytarabine (AraC), maintenance therapy: 6-mercaptopurine, cyclophosphamide, MTX, DNR, VCR and AraC. Patients received chemotherapy for 3 years after achieving complete remission (CR). CR was obtained in 51 patients (92.7%). Twenty-four of them relapsed after achieving CR (bone marrow 16, CNS 3 and testis 5). At median follow-up of 79 (range 64-102) months, the estimated 8-year disease free survival rate was 49.1 +/- 6.7%. Four patients relapsed at bone marrow during the first 6 months of the treatment, indicating that more intensive combination chemotherapy should be included in earlier stage of the protocol. The high incidence of testicular relapse (14.3% in boys) suggests that high-dose MTX or AraC should be needed for improvement of the prognosis of high-risk ALL patients.

Age Factors↗

PubMed1994

[Clipping of aneurysm arising from the posterior communicating artery itself by contralateral craniotomy: a case report].

A case of aneurysm arising from the posterior communicating artery itself clipped by contralateral frontotemporal craniotomy (pterional approach) is presented. A 65-year-old female developed sudden severe headache and chest pain in January of 1993. Neurological examination on admission revealed consciousness disturbance such as stupor and nuchal stiffness. CT-scan showed marked subarachnoid hemorrhage. She also suffered from acute myocardial ischemia and cardiac failure. Cerebral angiograms after recovery from cardiac dysfunction demonstrated three saccular aneurysms arising from the dilated right posterior communicating artery itself, the junction of the left internal carotid artery and the posterior communicating artery, and the bifurcation of the left middle cerebral artery. The left IC-PC junction aneurysm was thought to be ruptured because of its size and contour, so left frontotemporal craniotomy was undertaken. By the left pterional approach, successful clipping of all three aneurysms involving the one arising from the contralateral posterior communicating artery was achieved. The aneurysm at the posterior communicating artery itself was found to arise from the non-branching site and to project inferiorly, thus the successful clipping through the prechiasmal cistern could be performed without compromising any small perforating arteries.

Aged↗

PubMed1994

[Clinical effect of the combined therapy of arbekacin and imipenem/cilastatin against methicillin-resistant Staphylococcus aureus].

We evaluated the efficacy of combined therapy of arbekacin (ABK) and imipenem/cilastatin (IPM/CS) against infections by methicillin-resistant Staphylococcus aureus (MRSA). The MICs of ampicillin, cefmetazole, cefotiam, cefuzonam, flomoxef, fosfomycin, ofloxacin, minocycline, ABK and IPM/CS against clinically isolated strains of MRSA were examined. Almost all strains of MRSA were resistant to these antibiotics except ABK. Furthermore, combination of ABK and IPM/CS showed smaller MICs than that of ABK or IPM/CS alone. All fractional inhibitory concentration indices (FIC indices) of ABK plus IPM/CS were lower than 0.75. The efficacy rate of combined therapy of ABK and IPM/CS in 22 patients with MRSA infections (15 patients with pneumonia, 3 patients with chronic bronchitis, 2 patients with sepsis, a patient with subcutaneous abscess and a patient with DPB) was 68%. And no patients had adverse reactions. Six (27%) of 22 strains of MRSA were eradicated. Significant correlations were found between bacteriological effect and severity of disease, and between serum albumin level and clinical effect.

Aged↗

PubMed1994

[A case of sarcoidosis presenting with hoarseness and dysphagia due to glossopharyngeal and vagus nerve paresis].

The patient was a 20-year-old female who complained of hoarseness and dysphagia. Chest X-ray showed bilateral hilar lymphadenopathy. Sarcoidosis was diagnosed histologically on the basis of granuloma without necrosis, by transbronchial lung biopsy (TBLB). Bronchofiberscopic findings revealed no granuloma of the vocal cords. Examination of the central nervous system with MRI identified no abnormalities. Hoarseness and dysphagia were thought to have been caused by glossopharyngeal and vagus nerve paresis. These signs improved markedly after two weeks of steroid therapy. This is a rare case of sarcoidosis associated with glossopharyngeal & vagus nerve paresis.

Adult↗