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Biomedical subjects

H Udagawa

Publications and source records attributed to H Udagawa.

47 records · Page 3Linked to original sources
PubMed1993

[Fulminant streptococcal infection and sudden death in a pregnant woman: a case report].

A case of fulminant streptococcal infection occurring in a 28-year-old pregnant female is reported. She initially developed pharyngitis and high fever during the 33rd week of gestation. This was treated with oral piperacillin for two days with temporary amelioration. Recurrence of high fever, however, was noted shortly thereafter, which was followed by stillbirth of twin babies, and subsequent development of refractory hypotension and demise of the mother. Autopsy revealed presence of numerous cocci and fibrin thrombi in systemic circulation, and this was thought to be the immediate cause of her death. The causative organism was identified as Streptococcus pyogenes, M3, T3, and was found to be producing streptococcal pyrogenic exotoxin A in vitro. The underlying mechanism for this serious infection remains unknown.

Adult↗
PubMed1993

[Clinical effect and characteristics of low dose leucovorin and high dose 5-FU therapy in patients with recurrent gastric cancer--a new method of biochemical modulation].

The biochemical modulation of 5-fluorouracil (5-FU) and leucovorin (LV) has resulted in a remarkable increase of the response rate in patients with colorectal cancer. Recently, in the treatment of gastric cancer this biochemical modulation has been introduced into clinical practice and has also achieved good antitumor activity. A review of the literature indicates that 5-FU/LV therapy for gastric cancer is effective only when LV is administered at high doses (200 mg-500 mg/m2), and the efficacy of low dose LV (20 mg/m2) administration with the combination of high dose 5-FU is still unknown. Thirty-five patients with measurable recurrent gastric cancer received low dose LV and high dose 5-FU for 4 days. The schedule was as follows: iv injection of low dose leucovorin (20 mg/m2) and from one hour later 2-hour infusion of high dose 5-FU (700 mg/m2). This new treatment for recurrent gastric cancer achieved a response rate of 40.0%, and 80.0% of the patients with pronounced palliative effects measured as recurrence-related symptoms. It is very rare for 7 out of 8 patients (87.5%) to be relieved of obstructive jaundice, and we now prefer this therapy to percutaneous transhepatic biliary drainage in patients with jaundice. The toxicity of this biochemical modulation is leukopenia, stomatitis and diarrhea, and the number of patients with toxicity over grade 3 was 5 (14.3%). There was no treatment-related death.

Adult↗
PubMed1991

Transoral esophagectomy.

A technique for transoral esophagectomy is presented herein. The major advantages of this operative technique are: less tissue dissected, minimal chance of contamination of the surgical field and preservation of the vagus nerve when the occasion requires it. The operation can be done with small incisions, insignificant blood loss and, with more simplicity and safety than in other similar procedures.

Esophagectomy↗
PubMed1989

[Evaluation of the collo-thoraco-abdominal dissection for the intrathoracic esophageal carcinoma].

Five hundred and forty three cases of intrathoracic esophageal carcinoma were reviewed. Of these, one hundred and sixty one cases had collo-thoraco-abdominal (CTA) dissection and three hundred and eighty two cases had thoraco-abdominal (TA) dissection. Postoperative pulmonary complications occurred in 35.5% of the patients who had CTA dissection and in 18.0% of those who had TA dissection. Incidences of postoperative hoarseness of voice and anastomotic leakage were almost similar in the two groups. However, the mortality rates within 30 postoperative days was 4.3% for the CTA groups compared to 1.8% for the TA group. The average number of lymph nodes resected per case was much higher in the CTA group than than the TA group. This implied that the dissection was more extensively performed in the CTA group involving not only bilateral cervical regions but also the upper mediastinum continuing into the neck. Better 1, 2 and 3 years survival rates were observed in the CTA group than the TA group, but for the 4, 5 years survival rates there was no statistical difference noted. For stage-0 and stage-4 carcinoma of the upper third esophagus, marked improvement in the survival rates were obtained in the CTA dissection cases. In conclusion, collo-thoraco-abdominal dissection can be justified for the surgical treatment of intrathoracic esophageal carcinoma despite its postoperative mortality rate of 4.3%.

Abdomen↗
PubMed1984

Development of surgery for carcinoma of the esophagus.

During the period from October 1972 to January 1983, 462 patients with squamous cell carcinoma of the esophagus were admitted to Toranomon Hospital. Those patients with carcinoma of the hypopharynx, cervical esophagus, or cardia extending to the esophagus were excluded from the study. Resection and reconstruction were carried out in 295 patients with a resectability rate of 63.9 percent and an operative mortality rate of 1.7 percent. The 5 year survival rate for 101 patients who had resection with minimum 5 year follow-up was 34.7 percent. Although the ultimate outcome is largely influenced by the tumor type representing malignancy, it is worthwhile to make all efforts to resect the tumor with a negative surgical margin and to resect concomitant lesions if there are any. Surgeons should not be discouraged by the length or size of a tumor. The extent of positive lymph node is closely related to long-term results. However, systemic lymph node dissection should be carried out because 5 year survival can then be expected, even when positive nodes are dissected from various areas.

Carcinoma, Squamous Cell↗
PubMed1984

[Effects of estrogen, progesterone and androgen on autoradiograms of the immature rat uterus].

Endometrial cancer is more frequent in patients at a postmenopausal age, when the ovarian secretion of androgens instead of estrogens seems to be relatively increased. In clinical or experimental medicine, progesterones are widely used for the treatment of endometrial cancer, probably because they have an antiestrogenic action and cause differentiation of cancer cells from the proliferative phase. The effects of testosterone(T), progesterone(P), and/or 17 beta-estradiol(E) on the incorporation of 3H-thymidine in autoradiograms were investigated in immature rats. The autoradiogram revealed many grains due to 3H-thymidine in the endometrial epithelium, stroma, and the myometrium in the immature rat 30 hours after E-injection. T alone markedly induced the DNA synthesis in the stroma and the myometrium, but not in the epithelium. T displayed a synergistic interaction with E in both the stroma and the myometrium with a slight increase in thymidine incorporation into the epithelium. P alone induced DNA synthesis in the stroma and the myometrium. Simultaneous injection of E and P also produced the same result as that when P alone was injected. P markedly inhibited DNA synthesis due to E in the epithelium. Autoradiograms of the immature rat uterus provide basic support for the rationality of P therapy for cancer or adenomatous hyperplasia of the endometrium.

Androgens↗
PubMed1980

[Plasma estradiol concentration and uterine estrogen receptor in adult rats after steroid administration (author's transl)].

Interaction of estradiol and testosterone was studied at the level of cytoplasmic and nuclear estrogen receptors in the uterus of the adult rat. 55 Sprague-Dawley strain rats, 10 weeks old, were divided into 4 groups. Group I. 5 intact rats (proestrus). Group II. 30 rats were injected with long acting estradiol (ED: 1mg/0.2ml of estradiol dipropionate). Each 5 rats were sacrificed on day 1, 3, 5, 7, 11 and 14 days respectively after the ED injection. Group III. 10 rats were injected with ED. Vehicle (0.2ml of dimethyl sulfoxide) and 1mg/ 0.2ml of testosterone were injected from the 3rd day of the ED injection for 5 days into each 5 rats respectively. Group IV. 10 rats were injected with ED. The rats were treated similarly to Group III except that vehicle or testosterone injections began from the 7th day. Plasma estradiol was determined by RIA. The DCC method for cytoplasmic receptor assay and the pellet exchange method for nuclear receptor assay were used. As to unbound receptor assay, the material was incubated with tritiated estradiol at 0 degrees C for 2 hours. Incubation at 30 degrees C for 1 hour was added to the above for bound receptor assay. Plasma estradiol levels increased 1 day after the ED injection and remained very high for 7 days and decreased to five times that of intact rats 14 days after the injection. Plasma estradiol levels were not influenced by injections of vehicle or testosterone. In group II, cytoplasmic estrogen receptor decreased 1 day after the ED injection and remained low for 7 days and then returned gradually. In nucleus bound receptor increased. Fluctuation of estrogen receptors in uterine cytoplasma and nucleus was in accordance with the concentration of plasma estradiol. In Groups III and IV, there was no significant difference in cytoplasmic and nuclear estrogen receptors between vehicle and testosterone injections. Plasma estradiol levels and uterine cytoplasmic and nuclear estrogen receptors of the ED-treated rats were not influenced by testosterone injections. It is supposed that interaction of estradiol and testosterone may occur in the protein or DNA synthesis mechanism after the receptor level.

Animals↗
PubMed1978

Sex hormone-binding globulin and estrogen receptor in breast cancer: technique and preliminary clinical results.

The binding capacities of SHBG (sex hormone-binding globulin) and ER (estrogen receptor) were measured by agar gel electrophoresis with dextran-coated charcoal treatment and also by sucrose density gradient ultracentrifugation in the sera from 19 women with breast cancer to assay the correlation between SHBG and ER in breast cancer. SHBG levels were also measured by agar gel electrophoresis with dextran-coated charcoal treatment in control sera from 20 normal women. Two kinds of 17 beta-estradiol-binding substances were recognized in the cytosol of breast cancer cells and they were confirmed to be ER and SHBG. Out of 13 postmenopausal patients with breast cancer, the SHBG levels in 6 ER-positive cases (66 +/- 13 pmol/ml plasma, mean +/- SD) were significantly higher than the levels of 10 controls (35 +/- 7.6 pmol/ml; P less than 0.005). SHBG levels in 7 ER-negative patients (34 +/- 7.9 pmol/ml plasma) did not significantly differ from the levels of the controls, but differed significantly from the levels of ER-positive patients (P less than 0.005). Out of 6 premenopausal breast cancer patients, the SHBG levels in 5 ER-positive cases (63 +/- 7.5 pmol/ml plasma) tended to be higher than the levels in 10 controls (55 +/- 4.7 pmol/ml plasma), but did not achieve statistical significance (P greater than 0.05). The findings suggest that correlation between SHBG and ER in postmenopausal breast cancer is possible, but no significant difference was noted between the SHBG levels in ER-positive premenopausal breast cancer patients and premenopausal normal women.

Adult↗
PubMedDate not supplied

A new choleretic effect of folinic acid.

BACKGROUND/AIMS: In the chemotherapy of recurrent gastric cancer with 5-fluorouracil and folinic acid, an interesting phenomenon, the reduction of jaundice and improvement of liver function, was observed. The aim of this study was to investigate the mechanism of this phenomenon, and to confirm a choleretic effect of folinic acid. METHODOLOGY: The bile duct of anesthetized rats was catheterized, and bile was collected. Bile volume and total bile acid production following intraperitoneal administration of folinic acid were determined and compared to those of control rats. RESULTS: Both bile volume and total bile acid production increased following intraabdominal administration of folinic acid. CONCLUSIONS: Folinic acid has a newly described pharmacologic effect of stimulating bile acid-dependent choleresis. It is possible that folinic acid may become a new drug for the treatment of jaundice or for the improvement of overall liver function.

Animals↗