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Biomedical subjects

H Watanabe

Publications and source records attributed to H Watanabe.

At least 883 records · Page 49Linked to original sources
PubMed1998

Biochemical investigation of cell motile activity in rheumatoid synovial fluid.

OBJECTIVE: We have suggested that autocrine motility-like factor is expressed in rheumatoid synovial fluid (SF). We examined the biochemical features of the motile activity. METHODS: We investigated chemokinetic activities of SF from patients with osteoarthritis and joint trauma as well as rheumatoid arthritis (RA) using a unique protein-free culture fibrosarcoma system. We then investigated biochemical features and the signal transduction pathway of the motile activity expressed in RA. RESULTS: We found chemokinetic activity in SF from all patients. However, ability to block binding of the monoclonal antibody to the receptor for autocrine motility factor (AMF) was observed only in rheumatoid SF on immunoblots. Biochemical investigation indicated motile activity to be heat labile, trypsin sensitive, and eluted at high salt concentration from an anion exchange column. Stimulated motility of rheumatoid SF was inhibited by the pertussis toxin, staurosporine (C kinase inhibitor), and genistein (tyrosine kinase inhibitor), but not by A kinase inhibitor, H-8. CONCLUSION: The cell motility activity expressed in rheumatoid SF appears to be AMF, and the cytokine may be essential for communication among leukocytes in rheumatic disease.

Animals↗
PubMed1998

[A case of intrathoracic chronic expanding hematoma].

A chronic expanding hematoma in the thoracic cavity is very rare and is clinically included in a category of chronic hemorrhagic empyemas as a special type of chronic empyemas in Japan. In this paper, we report a case of this disease. The patient was a 69-year-old female, who was underwent bilateral artificial pneumothorax for pulmonary tuberculosis 35 years ago. On 25. Nov. 1996, she admitted into Nagoya University Hospital for a diagnosis of intrathoracic tumor. On 2. Dec. 1996, we removed the tumor with combined resection of left lower lobe. The tumor was diagnosed pathologically as an intrathoracic chronic expanding hematoma. This disease is benign, but progressive clinically. In progressive case it is dangerous to remove the tumor for a risk of excessive bleeding and hard adhesion to the chest wall. So we think the earlier is a surgical treatment, the better is a management for this disease.

Aged↗
PubMed1998

[Evaluation of the temperature dependent flow rate in three portable epidural infusion devices].

We evaluated the temperature dependent flow rate of local anesthetics, 0.25% bupivacaine, in three portable epidural infusion devices, Infusor of Baxter, Surefuser-A of Nipro and Excelfuser of Kobayashi Medical. Flow rate was calculated using a digital precision scale in a large temperature controlled incubator. In two preliminary studies the temperature was 25 degrees C at the patient's side and 33 degrees C on the patient's skin. All the devices increased the flow rate with an increase in temperature and there were no clinically significant differences in the infusion quality and stability. It should be remembered that the flow rate of Excelfuser is 30% greater at 33 degrees C than the inscribed value, because this calibration temperature of 22 degrees C (a new type calibrated at 32 degrees C will come to the market soon) is about 10 degrees C lower than that of others. In critical patient care we should watch the temperature of the flow controller. Additionally, according to our viscosity measurement study, we conclude that temperature depended flow rate changes are related not to the inner diameter of the flow controller, but to the viscosity of local anesthetics.

Anesthesia, Epidural↗
PubMed1998

[The autopsy case of traumatic carotid artery dissection].

The results of an autopsy of a 78-year-old female patient with an occluded of the right internal carotid artery after a traffic accident are reported. She presented with consciousness disturbance, right conjugate deviation, left hemiparesis and left pathological reflex. Evidence of right skull and clavicular fractures seemed to suggest that severe hyperextension of her neck associated with contralateral lateral flexion had stretched her carotid artery. Although she was treated with antiplatelet therapy, her cerebral swelling due to right global infarction progressed and she died due to bilateral cerebral herniation three days after injury. The autopsy disclosed right dissecting carotid artery occlusion and subadventitial dissection was revealed histologically. When a hematoma dissect the media and adventitia of the carotid artery wall, the outer wall weakens and may dilate without narrowing the lumen of the carotid artery. In this case, the vessel occlusion was considered to be due to a primary intramural hematoma which developed and subsequently ruptured through the intima into the vessel lumen. Early diagnosis and treatment are necessary for improving the prognosis of this disease entity. A patient with poor colateral flow, such as in this case, will show a rapid progression of cerebral infarction. It is best to consider surgical treatment in this case if the other traumatic lesions are able to tolerate surgery.

Aged↗
PubMed1998

[Randomized, double-blind, placebo-controlled study of supplemental vitamin E on attenuation of the development of nitrate tolerance].

The attenuation of intracellular production of cyclic guanosine monophosphate (cGMP) has been known as a mechanism of nitrate tolerance. A recent in vitro study have shown an increase in superoxide levels and a reduced activation of guanylate cyclase in tolerant vessels. We investigated the preventive effect of an antioxidant, vitamin E, on the development of nitrate tolerance. In this double-blind, placebo-controlled study, 24 normal volunteers and 24 patients with ischemic heart disease (IHD patients) were randomized to receive either vitamin E (200 mg t. i. d.; vitamin E group) or placebo (placebo group). Vasodilator response to nitroglycerin was assessed with forearm plethysmography by measuring the change in the forearm blood flow before and 5 min after sublingual administration of 0.3 mg nitroglycerin, and at the same time, blood samples were taken from veins to measure the platelet cGMP level. Measurements of the forearm blood flow and blood sampling were obtained serially at baseline (day 0), 3 days after taking vitamin E or placebo alone (day 3), and 3 days after application of a 10 mg/24 hr nitroglycerin tape concomitantly with oral vitamin E or placebo (day 6). The response of forearm blood flow (%FBF) and cGMP (%cGMP) after sublingual nitroglycerin on day 0(%FBF: normal volunteers 32 +/- 12% vs 31 +/- 11%, IHD patients 35 +/- 15% vs 34 +/- 15%; %cGMP: normal volunteers 38 +/- 10% vs 35 +/- 11%, IHD patients 37 +/- 11% vs 38 +/- 12%; vitamin E group as placebo group) and day 3(%FBF: normal volunteers 33 +/- 9% vs 32 +/- 12%, IHD patients 35 +/- 12% vs 33 +/- 13%, %cGMP: normal volunteers 38 +/- 10% vs 37 +/- 11%, IHD patients 36 +/- 14% vs 37 +/- 10%, vitamin E group vs placebo group) were not different between the two groups. On day 6 %FBF and %cGMP in the placebo group were significantly lower compared with day 0, and there were significant differences in them between the two groups (%FBF: normal volunteers 30 +/- 12% vs 17 +/- 9%, p < 0.01; IHD patients 28 +/- 14% vs 17 +/- 8%, p < 0.01; %cGMP: normal volunteers 35 +/- 11% vs 8 +/- 5%, p < 0.01; IHD patients 38 +/- 10% vs 12 +/- 4%, p < 0.01, vitamin E group vs placebo group). In conclusion, the combination therapy with vitamin E is potentially a useful method to prevent the development of nitrate tolerance.

Aged↗
PubMed1998

Mutations of p53 in gallbladder carcinomas in high-incidence areas of Japan and Chile.

Gallbladder adenocarcinomas from patients in two high-prevalence areas, Niigata (Japan) and Santiago (Chile), were analyzed for acquired mutations in exons 5-8 of the p53 tumor suppressor gene, and the characteristics of p53 alterations in the two groups were compared. Of 42 tumors, 22 (52.4%) harbored 25 alterations identified by PCR amplification and direct sequencing (13 of 22 tumors from Niigata and 12 of 20 tumors from Santiago). All alterations were single base pair substitutions, 20 (80%) leading to an amino acid substitution or a chain-termination signal, and 5 (20%) were silent. Immunohistochemically, 55 of 84 cases (65.5%) showed overexpression of p53 protein, with no significant difference in frequency between the two areas. Missense mutations correlated highly with overexpression of the p53 protein (93.4%). Mutations of p53 occurred in all four exons examined, most commonly in exon 5, but in no particular "hot spot." In base-change spectra, all 12 mutations from Santiago showed transitions, with 4 arising at the CpG dinucleotide (33.3%). In contrast, no such transition was found at CpG sites in Niigata, and 4 of 13 mutations (30.8%) were transversions. The data indicated that p53 mutations are highly important in carcinogenesis in the gallbladder. In addition, the difference in p53 mutational spectra in Niigata and Santiago indicate a likely regional difference in mutagenesis.

Adult↗
PubMed1998

[Continuous intraportal chemotherapy for prevention of metachronous hepatic metastasis in colorectal cancer].

Fifty-five colorectal cancer patients who had continuous intraportal chemotherapy between 1990 and 1993 (treated group) and 130 colorectal cancer patients who did not have portal chemotherapy between 1982 and 1993 (untreated group) were studied to clarify the effects of continuous intraportal chemotherapy on the prognosis. After a catheter was placed in the portal vein through the right gastroepiploic vein at the time of radical operation, 10 mg of MMC was continuously infused for 4 hours at operation and 500 mg/day of 5-FU was continuously infused for 7 days postoperatively. The toxicities of this therapy were not serious. The five-year survival rate was 65.3% in the treated group and 65.6% in the untreated group. The five-year disease-free survival rate was 69.8% in the treated group and 58.6% in the untreated group, with no significant difference. In stage II patients, however, the five-year disease-free survival rate in the treated group was slightly higher than in the untreated group (90.0% vs 70.3%, p = 0.073), and the rate of hepatic recurrence in the treated group was significantly lower than in the untreated group. These results suggest that continuous intraportal chemotherapy may prevent metachronous hepatic metastases in stage II colorectal cancer patients.

Aged↗
PubMed1998

Overgrowth of the ischial tuberosity complicating femoral bone and muscle atrophy: implications for a delayed complication of malunited apophyseal avulsion fracture.

Delayed complications occurring several years after the fused avulsion of ischial tuberosity have rarely been reported. We present a patient with overgrowth of the ischial tuberosity who complained of knee pain associated with significant bone and muscle atrophy in the thigh, which occurred 10 years after the ischial injury. Reinforcement exercise of the hamstrings relieved the knee pain. Here, we emphasize that avulsion fractures of the ischial tuberosity can cause persistent disability and that patients with avulsion fracture of the ischial apophysis in the adolescent period should actively maintain the strength of the hamstrings, even after more than 1 decade.

Adult↗
PubMed1998

[Clinical effect of propiverine hydrochloride on urinary incontinence].

Propiverine hydrochloride was given to patients with subjective symptoms of urinary incontinence and its effect was evaluated in relation to the pathogenesis of incontinence. High improvement rates were obtained in patients with stress incontinence as well as those with urge incontinence. There was no significant difference between the two patient groups in the degree of improvement of subjective symptoms or objective findings. Under the present circumstances, where urinary incontinence is often treated by medical doctors other than urologists, this drug may be useful for the treatment of urinary incontinence since it would produce high therapeutic effects irrespective of the pathogenesis of incontinence.

Adult↗
PubMed1998

[EPOCH therapy for relapsed/refractory lymphoid malignancies].

Patients with refractory or relapsed non-Hodgkin's lymphoma (NHL), acute T-cell leukemia (ATL), ATL lymphoma and acute lymphocytic leukemia (ALL) received EPOCH therapy. All were previously treated with doxorubicin (DOX), vincristine (VCR) and other drugs. The EPOCH treatment schedule is consisted with DOX (10 mg/M2/day, 5 days c.i.v.), VCR (0.4 mg/M2/day, 4 days c.i.v.), etoposide (50 mg/M2/day, 4 days c.i.v.), cyclophosphamide (750 mg/M2/day, day 6 i.v.) and prednisolone (60 mg/M2/day, 5 days p.o.). Twenty-one patients (ALL:10, NHL:8, ATLL:2, ATL:1) were assessable for response and toxicity. Two patients with ALL and NHL, respectively, achieved a complete remission and 3 patients obtained partial remission (NHL:2, ATLL:1). The hematological toxicity (grade > 1) included neutoropenia, anemia and thrombocytopenia, which were observed in 83.3%, 76.7% and 76.7% respectively, of total 30 EPOCH courses. The major non-hematological toxicities were nausea/vomiting, constipation and infection, but most of the toxicity were tolerable with sufficient clinical supportive care. These results indicate that continuous infusion of DOX, VCR and ETP might be effective in patients who were treated with, and presumed to be resistant to the same drugs administrated by bolus infusion.

Adolescent↗
PubMed1998

[Primary cardiac non-Hodgkin's lymphoma].

A 69-year-old man who initially presented with lumbago developed heart failure during an MRI scan on the day of admission. A chest X-ray showed cardiomegaly and bilateral pleural effusion. Echocardiogram and computed tomography (CT) scan of the chest revealed a large tumor mass encompassing the heart with much pericardial effusion was demonstrated. The cytology of the effusion obtained by pericardiocentesis was consistent with non-Hodgkin's lymphoma, diffuse large B cell type. As CT scans of the abdomen and pelvis were negative, he was considered to have primary cardiac lymphoma. Although he responded remarkably to therapy with vincristine, cyclophosphamide and prednisolone and, he developed acute respiratory failure on the seventh month after admission. Although incidence of primary cardiac lymphoma is very low, it is necessary to investigate the mechanism of this disease in order to establish appropriate diagnostic and therapeutic approaches.

Aged↗
PubMed1998

Calcific tendinitis in the posterior proximal thigh as a self-limited condition: pathogenic role of inflammatory responses.

OBJECTIVE: Calcific tendinitis occurs rarely in the posterior proximal thigh. We investigated whether it is self-limited and how the natural course of the disease progresses. METHODS: We treated 6 patients with no surgical intervention, and analyzed laboratory and radiological findings in the followup period of more than one year (average followup, 2.5 yrs). RESULTS: Although tendinitis was severe, rapid relief was observed within 2 weeks (average 5 days). Radiological features including extraskeletal calcifications did not change within 2 weeks, and then improved by 6 weeks. Four of 6 cases showed abnormal laboratory variables. All elevated white blood cell counts and C-reactive protein levels improved within one week with clinical resolution. In comparison with time course of the symptoms, changes in the radiological findings over time appeared not to be parallel with the clinical course, but laboratory progression appeared to correspond well with clinical resolution. CONCLUSION: Inflammatory responses to hydroxyapatite crystals may play a role in the pathogenesis of symptoms of calcific tendinitis in the posterior proximal thigh, most of which are self-limited.

Adult↗
PubMed1998

Infrequent expression of p21 is related to altered p53 protein in pancreatic carcinoma.

This study is designed to investigate the expression of p21 and its relation to altered p53 protein in pancreatic carcinoma (PC). Immunohistochemical staining of formalin-fixed, paraffin-embedded tissue sections of PC was performed using a monoclonal antibody against p21 (187), with a parallel examination of altered p53 protein. The expression of p21 was only found in 12 of 58 (20.7%) PCs and, moreover, was mainly restricted to the well-differentiated ductal epithelium. Sixty-four % (37 of 58) of PCs showed positive p53 staining, and this change was significantly related to the absence of p21 expression (P < 0.01). In a subgroup, the proportion of the undetectable p21 expression and the expression of p53 were increased with increasing tumor grade but decreased with advancing clinical stage. The results of the present study suggest that the absence of p21 expression is very common in PCs and appears to relate to altered p53 protein. Moreover, the abnormalities involving the expression of p21 and p53 may play a more important role in the development than in the progression of this malignancy.

Adult↗
PubMed1998

[Adjuvant chemotherapy with UFT or UFT with OK-432 to patients with gastric and colorectal cancer. Kanto Adjuvant Study Group].

In Japan, long-term oral therapy with tegafur in combination with immunopotentiators is commonly used as adjuvant therapy after curative resection of gastric or colorectal can for gastric and colorectal cancer. When the outcome was analyzed in terms of the relative performance (R.P.) and the individual dose intensity (I.D.I.) of OK-432, gastric cancer patients with a R.P. of 0.5 or higher tended to have a better survival curve. There were no marked differences in lymphocytes subsets, except that the Leu 7 level at 3 months after gastric cancer resection was significantly higher (p < 0.05) in group B than in group A. Thus, no inhibition of the anticancer effect of UFT was noted during long term combination therapy with UFT and an immunopotentiator as postoperative adjuvant therapy for patients who underwent curative resection of gastric or colorectal cancer. The results suggest that UFT combined with long-term OK-432 maintenance therapy may contribute to improve survival rates in gastric cancer patients.

Adjuvants, Immunologic↗
PubMed1998

[The significance of hypoplasia of the circle of Willis in patients with Binswanger-type cerebrovascular disease].

We evaluated the correlation between hypoplasia of the circle of Willis detected by MR angiography and ischemia of the white matter in patients with Binswanger-type cerebrovascular disease. We defined P1 hypoplasia as the condition in which the posterior cerebral artery at P1 protein was narrower than the posterior communicating artery, and A1 hypoplasia as that in which the ratio of the one anterior cerebral artery to the other at A1 portion was 1:2 or less. Of 68 patients with this disease. 33 (48.5%) had P1 hypoplasia and 23 (30.9%) had A1 hypoplasia. These incidences were significantly higher than those of patients with lacunar infarction (138 cases), where P1 and A1 hypoplasia were 29.0% and 18.1% respectively. P1 hypoplasia tended to be found more frequently in patients with lacunar infarction having advanced periventricular hyperintensity than in those having mild one. The large intracranial vessels, as seen by MR angiography, were less stenotic, and the serum concentration of apolipoprotein A-I was higher and B/A-I was lower in hypoplasia cases suffering from Binswanger-type cerebrovascular disease than in non-hypoplasia cases. In summary, hypoplasia of the circle of Willis was considered to precipitate the onset or progression of this disease without any relationship to arteriosclerosis.

Aged↗
PubMed1998

[A case of sea water and sand aspiration during near drowning].

A 46-year-old man who had been pulled under water by a tidal wave when an earthquake occurred on July 12, 1993 was carried to our hospital the next day. He soon needed endotracheal intubation and mechanical ventilation because he expectorated sputa with sand and because arterial bloodgas analysis revealed severe hypoxemia. Chest X-ray on admission showed diffuse small nodules and areas of consolidation. Chest CT obtained on July 16 showed centrilobular small nodules bilaterally and alveolar opacities in the peribronchial region. After therapy with antibiotics and frequent bronchial lavages, sputum with sand disappeared on the 14 th hospital day and chest X-ray film and laboratory data showed marked improvement. He was discharged on October 1. A chest CT scan obtained on February 17, 1994 showed improvement of the small nodules. The areas of consolidation had also improved, but remained as linear and nodular opacities, which were considered to be organized lesions. There are few reports concerning radiographic findings particularly CT findings, after aspiration of sea water and sand during near drowning.

Anti-Bacterial Agents↗