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Biomedical subjects

H Tokunaga

Publications and source records attributed to H Tokunaga.

At least 91 records · Page 5Linked to original sources
PubMed1997

[A case of complete remission of gastric endocrine cell carcinoma with multiple bone metastasis by combination chemotherapy and high-dose chemotherapy with autologous peripheral blood stem cell transplantation].

A 31-year-old man was admitted to our hospital complaining of epigastric discomfort and severe lumbago. An upper gastrointestinal endoscopy revealed several submucosallike tumors. Histologic examination of biopsy specimens confirmed the presence of endocrine cell carcinoma. Gallium scintigraphy and CT revealed multiple bone metastasis. He was treated with 6 cycles of combination chemotherapy consisting of CDDP, etoposide, CPA, EPI and VCR. Both gastric tumors and bone metastasis completely disappeared. After 7 cycles of the chemotherapy, he was treated with HDCT with PBSCT. There was no severe complication. This result suggested that the combination of conventional chemotherapy and HDCT with PBSCT was useful in cancer patients with poor prognoses, such as advanced gastric endocrine cell carcinoma.

Adult↗
PubMed1997

Plasma concentrations of antipsychotic drugs in psychiatric inpatients.

In current psychiatric therapy, two or more kinds of antipsychotic drugs are usually prescribed in Japan. However, there are few data on the therapeutic plasma concentrations of antipsychotic drugs or on the correlation between the daily dose and the plasma concentration, in cases where several antipsychotic drugs had been prescribed for each patient. We measured the therapeutic plasma concentrations of 9 antipsychotic drugs in 24 psychiatric inpatients during a 6-month period. They were treated with fixed dosages of antipsychotic drugs. Plasma samples were collected early in the morning once a month, and the concentrations of antipsychotic drugs were determined by gas chromatography with nitrogen phosphorus detection, high-performance liquid chromatography (HPLC) with fluorescence detection and HPLC with UV detection. The plasma levels of chlorpromazine, levomepromazine, thioridazine, haloperidol, bromperidol, zotepine, oxypertine, sulpiride and sultopride were 21.8-92.4, 31.7-156, 101-203, 16.4-56.2, 2.72-11.7, 13.6-84.0, 29.9-80.4, 70.1-1,120 and 35.7-2,990 ng/ml, respectively. A linear correlation between the daily dose and the plasma concentration was noted for sultopride, levomepromazine, sulpiride, haloperidol, chlorpromazine and zotepine.

Adult↗
PubMed1996

Expression of IL-6, IL-8, and RANTES on human bronchial epithelial cells, NCI-H292, induced by influenza virus A.

Bronchial epithelial cells are primary sites of airway viral infection, and these cells may play an important role in the pathogenesis of respiratory diseases. It has recently been reported that bronchial epithelial cells express RANTES. RANTES attracts monocytes, T cells, eosinophils, and basophils; it can also activate eosinophils. To determine whether viral infection induces RANTES expression on bronchial epithelial cells, we infected a bronchial epithelial cell line, NCI-H292, with influenza virus A (H3N2). We then examined the concentration of RANTES in the culture medium of infected cells by ELISA and assessed expression of the gene for RANTES by the reverse-transcriptase polymerase chain reaction. We also investigated the concentrations of IL-6, IL-8, and granulocyte-macrophage colony-stimulating factor in the medium of infected cells, because some virus infections have been reported to induce expression of these cytokines on bronchial epithelial cells, but there are few data concerning influenza virus infection. Small amounts of IL-6 and IL-8 were detected in the medium of uninfected cells. RANTES was not detected in the medium of uninfected cells. After influenza virus infection, significant amounts of IL-6, IL-8, and RANTES were released into the culture medium of infected cells, and RANTES messenger RNA was detected from infected cells. Granulocyte-macrophage colony-stimulating factor was not detected in the medium of uninfected and infected cells. These results suggest that influenza virus infection may stimulate production of IL-6, IL-8, and RANTES from human bronchial epithelial cells and that these cytokines may contribute to the pathogenesis of airway inflammatory diseases caused by influenza virus infection.

Base Sequence↗
PubMed1996

Eosinophil peroxidase deficiency in New Zealand white mice.

Eosinophil peroxidase (EPO) is one of the granule enzymes in the eosinophil-specific granules and is distinct from myeloperoxidase. Here we report that peroxidase activity was absent in eosinophils of New Zealand White (NZW) mice. When NZW, New Zealand Black and their F1 mice were treated with cyclophosphamide followed by Toxocara canis infection, the kinetic changes in the number of eosinophils in peripheral blood, determined by counting in Hinkelman's diluting fluid, were almost comparable among the three strains. However, when their blood films were stained for peroxidase reaction, eosinophils of NZW mice, but not of the other strains, lacked EPO activity, though their specific granules were stained by eosin Y. Sudan black staining for phospholipid was also negative in eosinophils of NZW mice. EPO deficiency in NZW eosinophils was further confirmed by electron-microscopic observations and by measuring EPO activity in the extracts of eosinophil-rich cell suspensions. These results indicate that NZW eosinophils share most of the features with human EPO-deficient eosinophils, suggesting that the NZW mouse is a murine counterpart of human EPO deficiency.

Animals↗
PubMed1996

Lysosomal cysteine and aspartic proteinases and ubiquitin in rat and human urinary bladder epithelium.

To examine localization of cysteine and aspartic proteinases, and ubiquitin in rat and human urinary bladders, immunocytochemistry was applied to the tissues. In semi-thin sections, immunoreactivity for cathepsins B and D was densely localized throughout epithelial layers of rats and humans, while that for cathepsins H and L was mainly localized in rat superficial and human intermediate cells. Immunoreactivity for cathepsin C was relatively high in rat and human epithelia, especially in humans. Immunoreactivity for ubiquitin was detected in rat and human epithelial cells. By electron microscopy, vesicular or heterogeneously dense lysosomes labeled with immunogold particles indicating cathepsin B were seen in rat and human epithelial cells; particularly, they often appeared near fusiform vesicles in rat superficial cells and in human intermediate and superficial cells. By double immunostaining, lysosomes with or without vesicular structures were co-labeled with immunogold particles showing both cathepsin B and ubiquitin. The results suggest that cathepsins B, C, H, and L, and cathepsin D are involved in the lysosomal system of rat and human bladder epithelia. Moreover, considering that ubiquitin is a cofactor in the soluble ATP-dependent proteolysis, the results may also indicate that epithelial cells actively form autophagolysosomes.

Animals↗
PubMed1996

Postnatal development of the blood vasculature in the rat adrenal gland: a scanning electron microscope study of microcorrosion casts.

Postnatal development of the blood vasculature in the rat adrenal gland was examined with scanning electron microscopy (SEM), using a microcorrosion casting method. The cortical vascular bed on postnatal day 1 (P1) was incipient, consisting of an outer capillary layer and an inner sinusoidal vascular layer of the juxtamedullary zone. The vascular bed grew continuously with clearer zonal differentiation as the maturation proceeded. By P7 the outer capillary layer had differentiated into the vasculature of the glomerular and fascicular zone, while the juxtamedullary sinusoidal vascular layer had reduced its thickness to differentiate into the vasculature of the reticular zone. The neonatal adrenal vasculature consisted only of the cortico-medullary system. The medullary arteries and the medullary capillary bed were first observed on P14. The adrenomedulla thus came to receive a twofold blood supply by this time. Before the establishment of the medullary arterial system, the medulla appeared to receive its blood supply partly from the cortical capillaries and partly from the radial sinusoidal vessels passing through the cortical vascular bed. The radial sinusoidal vessels were suggested to differentiate into the cortical capillaries. The medullary arteries may originate from the vessels associated with chromaffin bodies incorporated into the adrenal gland or differentiate from the radial sinusoidal vessels. Histological changes, including cortical cell involution and hemorrhage occurring during the neonatal period, would seem to have crucial relevance to the remodeling of the adrenal vasculature.

Adrenal Cortex↗
PubMed1996

Rotational obstruction of nondominant vertebral artery and ischemia. Case report.

A 70-year-old man presented with repeated vertebrobasilar insufficiency for 3 years. Four-vessel angiography revealed complete occlusion of the nondominant left vertebral artery on head turning to the right. Three-dimensional computerized tomography angiography demonstrated atlantoaxial joint dislocation when the head was turned to the right, in accordance with simultaneous occlusion of the left vertebral artery caused by stretching of the artery at C1-2. After posterior fixation of C1-2 by a Halifax interlaminar fixation system, the patient had no further episodes. Hemodynamic function associated with nondominant vertebral artery occlusion contributed to the symptoms in this case.

Aged↗
PubMed1996

Screening of antipsychotic drugs by wide-bore capillary gas chromatography with nitrogen phosphorus detection--detection levels in plasma.

The detection levels of 12 antipsychotic drugs as ascertained from drug screening were examined in order to use the screening results effectively for treatment of patients or medico-legal examinations in cases of poisoning. Wide-bore capillary gas chromatography with nitrogen phosphorus detection was used for the analysis. The detection limits of drugs in plasma using 3 extraction procedures, single-solvent, 3-step solvent and solid-phase extractions were 50-100 ng/ml, 10-200 ng/ml and 5-50 ng/ml, respectively. The detection limits were compared with blood levels previously reported in the literature. Only 4 drugs were detected at the therapeutic level, thioridazine, floropipamide, sultopride and oxypertine using the single-solvent extraction procedure. Using the 3-step solvent extraction procedure, chlorpromazine, levomepromazine and zotepine in addition to the above 4 drugs were detected. Using the solid-phase extraction procedure, 8 of 12 drugs were able to be detected at the therapeutic level, with the exception of perphenazine, haloperidol, bromperidol and nemonapride. These data were proved to be useful for a rapid forensic diagnosis.

Antipsychotic Agents↗
PubMed1996

Human brain disturbance by methylmercury poisoning, focusing on the long-term effect on brain weight.

The long-term effects of the initial methylmercury exposure in the Minamata area were examined, with focus on brain weight. Comparisons were made between the brain weights of methylmercury-contaminated persons in the Minamata area (cases) and those of Japanese who suffered sudden or accidental death without brain disease (controls). Since over thirty years have passed since the outbreak of Minamata disease, subjects aged 30 or over at death were included in the analysis. The total number of cases was 417 (273 males, 144 females) and that of controls was 2,934 (2,174 males, 760 females). The data suggest that the brain weights from Minamata cases were reduced by 80 to 200g as compared to the controls. These results may indicate that methylmercury exposure led to a decrease of nerve cells (single cell necrosis), so-called "thinning out", in the brain cortex.

Adult↗
PubMed1996

[A case report of a left bronchial stump fistula from which the wrapped omentum was removed, because of rupture of the anastomotic aneurysm of the descending thoracic aorta--functions of the wrapped omentum in the early phase and extended phase after surgery].

The omental wrapping is a method of the choice for empyema with bronchopleural fistula. A 71-year-old woman, who had undergone graft replacement for the aneurysm of the descending thoracic aorta, underwent left pneumonectomy for lung abscess. Two months after surgery, the bronchopleural fistula in the stump was presented and successfully repaired by omentopexy. When anastomotic aneurysm rupture of the graft was presented one year later, the management was successful because mortal bleeding was prevented by the omental pedicle flap in the left thoracic cavity. Though we removed the omental flap with hematoma, the fistula didn't recurred. The omentum facilitates the healing of bronchopleural fistula in the early phase after surgery, but the healing course in the extended phase had not have any trouble without omental vascularization.

Aged↗
PubMed1995

Effects of intravenous nitroglycerin combined with dopamine on intracranial pressure and cerebral arteriovenous oxygen difference in patients with acute subarachnoid haemorrhage.

The effects of intravenous nitroglycerin (NTG) combined with dopamine on intracranial pressure (ICP) and cerebral arteriovenous oxygen difference (AVDO2) were studied in 11 patients with acute subarachnoid haemorrhage (SAH). The study was performed on Days 1 to 3 of SAH after aneurysmal clipping. Treatment consisted of an intravenous drip infusion of NTG in increasing incremental doses of 0.5, 1.0, 1.5, 2.0, and 2.5 micrograms/kg/min at one-hour intervals. Dopamine (5 to 10 micrograms/kg/min) was also given concurrently to maintain systemic blood pressure. ICP values before NTG administration ranged from 7 to 24 mmHg (mean. 11.91 +/- 5.30 mmHg). ICP began to increase immediately after the administration of NTG 0.5 microgram/kg/min and peaked at 14.64 +/- 5.93 mmHg 10 minutes after onset of infusion. Thereafter, ICP gradually returned to pretreatment levels. Increasing the dose of NTG failed to induce further significant rises in ICP. Mean AVDO2 before NTG administration was 4.69 +/- 0.62 ml/dl. This parameter showed no significant change during NTG infusion, although cerebral perfusion pressure decreased to between 75% to 94% of the control value after NTG administration. These results indicate that continuous NTG infusion combined with dopamine does not have adverse effects on ICP (the ICP increase is minimal and transient) and may even have beneficial effects on CBF in patients with acute SAH.

Adult↗
PubMed1995

Direct approach to intracranial vertebral arteriovenous fistula. Case report.

A case of intracranial vertebral arteriovenous fistula is reported. The treatment of choice for this particular vascular malformation is controversial because of the difficulty of management of the intracranial portion of the lesion. We here report a case treated successfully by direct surgery. Its anatomical delineation and operative approach are discussed.

Adult↗
PubMed1995

[A case report of prosthetic valve replacement for malfunction of the Hancock valve in mitral position associated with recurrent peptic ulcer and renal dysfunction].

A 62-year-old woman was admitted with malfunction of the Hancock valve in mitral position. She had been suffering from gastroduodenal ulcer for about ten years. She couldn't take warfarin after 5 years later of the initial operation due to recurrent gastrointestinal bleeding. Judging from her age and renal dysfunction, we preferred mechanical valve to avoid the risks for the reoperation. After confirming the healed ulcer with administering omeprazole, we performed prosthetic valve replacement with SJM 29 M successfully. Postoperative course was uneventful and recurrence of the ulcer was not observed.

Female↗
PubMed1995

[A case report of bentall type operation for annuloaortic ectasia with anomalous origin of the right coronary artery complicated by aortic dissection].

A 49-year-old woman of Marfan's syndrome, who had undergone replacement of the thoracoabdominal aorta for Stanford B type aortic dissection at 47 years of age, developed Stanford A type aortic dissection with annulo-aortic ectasia and aortic regurgitation. At the time of operation, anomalous origin of the right coronary artery from the left sinus of Valsalva and near site of the left coronary orifice were found. Then, composite graft replacement of the ascending aorta and aortic valve, in which a single graft of 16 mm in diameter was interposed between the coronary ostia and composite graft, was performed. Anomalous origin of the right coronary artery from the left sinus of Valsalva is a rare congenital abnormality. It is a matter how to reconstruct the coronary circulation for this type of operation. This technique was useful to reconstruct the aortic root even when an anomalous origin of the coronary artery existed.

Aortic Dissection↗
PubMed1995

Death due to asphyxia linked to antipsychotic drugs.

A 46-year-old man with schizophrenia, died in hospital. Autopsy revealed numerous facial injuries and the direct cause of death was apparently asphyxia as a large amount of coagulated blood was present in the lower part of the trachea and bronchi. The blood derived from a lacerated wound of the mouth. The question was raised as to why expectoration was impossible and a toxicological analysis was directed to the antipsychotic drugs allegedly prescribed by doctors at the hospital. Using gas chromatography and gas chromatography/mass spectrometry, four different antipsychotic drugs including chlorpromazine, levomepromazine, zotepine and haloperidol were identified in the whole blood and tissues with concentrations being 1.91, 0.75, 0.61 and 0.48 micrograms/g in the blood, respectively. These levels were toxic to the extent that he could not expectorate and blood accumulating in the airway led to asphyxia and death.

Antipsychotic Agents↗
PubMed1995

[RANTES expression on human bronchial epithelial cells].

Viral infection induces airway inflammation. It is possible that bronchial epithelium derived chemokine contributes to the migration and accumulation of inflammatory cells in the airway viral infection. We infected bronchial epithelial cells with influenza virus and analysed mRNA expression and production of RANTES. The expression of mRNA and the production of RANTES were detected in infected cells using RT-PCR method and ELISA.

Bronchi↗
PubMed1995

[Examination of cardiac myxomas complicated with embolism].

Cardiac myxomas complicated with embolism were examined. Of 51 patients who underwent surgical excision of myxomas during the last 19 years, 10 patients (6 patients originated from left atrium, 4 patients originated from right atrium) had complications by embolisms. The embolism occurred in cerebral arteries (5 cases), a coronary artery (1 case), a retinal artery (1 case), and pulmonary arteries (4 cases). Patients were divided into an embolism group and a non-embolism group to investigate risk factors of embolism. Arrhythmia, diameter, narrow peducle, and tumor friability were thought to be major risk factors. Gelatinous and rough surface type tumor tended to cause embolism. Hypervascular tumors did not cause embolism. Among 10 patients, 2 patients had already had new embolism and another 2 patients had aggravated their symptoms before making diagnosis of myxoma. Myxomas should always be considered as a source of embolization, which need meticulous investigation and prompt indication of surgical resection.

Adolescent↗