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Biomedical subjects

J Shibata

Publications and source records attributed to J Shibata.

At least 73 records · Page 4Linked to original sources
PubMed1989

[Intra-arterial injection of cisplatin suspension in Lipiodol (LPS) in the treatment of hepatocellular carcinoma].

Cisplatin suspension in Lipiodol (LPS) was prepared for the treatment of hepatocellular carcinoma by intra-hepatic arterial injection. In a rabbit liver cancer model, concentrations of cisplatin in tumor were more than 20 times higher than those in a nontumorous part of the liver at 5 min after LPS injection into the hepatic artery. Cisplatin at high concentrations was detected at 7 days after injection. The concentrations in other organs were lower except in the gall-bladder. In clinical trials for 71 patients with hepatocellular carcinoma, partial response was observed in 33 cases (46.5%) and minor response in 20 cases (28.2%). The survival rate was 77% at 6 month and 55% at one year. Although fever, nausea, vomiting and epigastralgia were observed as side effects, these were temporary. Acute gastroduodenal mucosal lesions, cholecystitis, pancreatitis, delayed jaundice and hepatic encephalopathy were observed as complications and super selective cannulation was necessary for their prevention.

Animals↗
PubMed1989

[Two cases of miliary tuberculosis with SIADH].

Two cases of miliary tuberculosis with syndrome of inappropriate secretion of antidiuretic hormone (SIADH) were reported. Case 1. A 70-year-old woman suffering from general fatigue and appetite loss developed neck stiffness and stupor three days after admission. The chest X-ray film showed a miliary pattern in both lungs. The lumber puncture showed high pressure and increased leucocytes in the cerebrospinal fluid. Serum natrium concentration was 113 mEq/L. Tubercle bacilli were seen in the broncho-alveolar lavage fluid by the Ziehl-Nielsen staining. An improvement in electrolytes balance was produced by 2.5% NaCl and antituberculous treatment, then her mental function recovered. Case 2. A 71-year-old man was admitted with gastric ulcer. When he developed dry cough thirty days after admission, the chest X-ray film showed a miliary pattern in both lungs. Acute respiratory failure advanced concomitantly. Tubercle bacilli were seen in the sputum (Gaffky 5) by the Ziehl-Nielsen staining. Antituberculous treatment was started. Although the miliary shadow improved gradually, hyponatremia was rather progressing. The following values for serum constituents were determined: sodium, 118 mEq/L; antidiuretic hormone, 10.3 pg/ml. Antituberculous treatment and supplement of NaCl (10 g/day) improved serum natrium level. He had no mental disturbance in his clinical course. In both cases, thyroid, renal and adrenal function were normal. Systemic edema and dehydration did not exist at the state of hyponatremia, and it was very clear that laboratory data were compatible with SIADH criteria. Miliary tuberculosis is one of the least commonly recognized causes of SIADH.

Aged↗
PubMed1988

The seroprevalence of anti-HTLV-1 antibodies in patients with various liver diseases.

The prevalence of antibodies to human T-cell leukemia virus type 1 (HTLV-1), which is linked to the etiology of adult T-cell leukemia (ATL), was examined in 380 patients with various liver diseases in Kumamoto Prefecture, southwestern Japan, which is one of the most endemic area for HTLV-1. Eighteen patients with acute hepatitis (AH), 201 chronic hepatitis (CH), 93 liver cirrhosis (LC) 40 hepatocellular carcinoma (HCC) and 28 with other liver diseases were examined. Among these patients, 110 patients had histories of blood transfusion. HTLV-1 specific antibodies were assayed by the ELISA method and the Western blotting method. The rate of positive reaction was 8.9% in all, 5.6% in AH, 6.0% in CH, 10.8% in LC, 17.5% in HCC and 14.3% in the cases of other liver diseases. The prevalence of anti-HTLV-1 antibodies in about 62,000 healthy blood donors in this area was 4.7%. The overall sero-prevalence in the patient group was significantly higher (p less than 0.001), than in healthy blood donors, particularly in the LC and HCC groups. Although the occurrence increased with age, no difference between sex was observed. Patients who had received blood transfusions were found to have a higher rate (17.2%), than those who had not (5.9%), and healthy blood donors. No difference was found between the two groups regarding family history of liver disease. This study indicates that blood transfusions may be an important route to the HTLV-1 infection.

Adolescent↗
PubMed1987

Deaths in early phase of acute myocardial infarction and approaches for reducing the in-hospital and out-hospital case-fatality rates of the disease.

Shiritsu Asahikawa Hospital received a total of 922 patients with acute myocardial infarction (AMI) from 1961 through 1985. The numbers of AMI patients and deaths during 1981-1985 were 2.8 times and 2.3 times, respectively, those observed during 1971-1975. However, decreasing trends were noted in the overall and age-adjusted mortality due to ischemic heart disease (IHD) per population of 100,000 Asahikawa residents between 1975 and 1984, suggesting a discrepancy between our CCU data and the city's records. We investigated the prehospital condition, out-of-hospital cardiac arrest, and the mechanism of early deaths in patients hospitalized with AMI. It was found that the increase of AMI patients admitted to our hospital was due to an increase in the hospitalization rate of AMI patients and the establishment of the coronary care unit (CCU) which allowed the admittance of patients who might have been declared dead out-of-hospital in the past. On the other hand, the declining trends in IHD mortality in the entire city of Asahikawa were attributable to reductions in the in-hospital and out-of-hospital fatality rates of patients with AMI, to improved hospital fatality rates of patients with AMI, and to improved survival rates in AMI patients who developed ventricular fibrillation (Vf) or who experienced out-of-hospital cardiac arrest episode. In order to further decrease the case-fatality rate of patients with AMI, it is essential to continuously educate residents on emergency treatment to be given at the onset of AMI.

Adult↗
PubMed1987

Histopathological study of acute myocardial infarction and pathoetiology of coronary thrombosis: a comparative study in four districts in Japan.

To clarify the patho-etiologic factors of Japanese myocardial infarction, a comparative pathological study of myocardial infarction in the Osaka, Akita, Wakayama, and Hokkaido districts, and an extensive histopathological study of 94 autopsy cases with acute myocardial infarct (AMI) in less than 4 weeks at Osaka were carried out. Although AMI in Akita was highly complicated by hypertension, AMI in Osaka was associated with a history of diabetes mellitus and hypercholesterolemia, especially in the young generation (under 59 years of age); hypercholesterolemia was related to the occurrence of AMI. Moreover, in spite of increases in transmural myocardial infarct (TMI) in Osaka, Hokkaido and Wakayama, Akita showed an equal ratio of TMI and subendcardial myocardial infarct. In AMI in Osaka, significant stenosis (more than 75% stenosis) of the coronary artery was of the same grade between the proximal and distal portions in the epicardial coronary artery. AMI in Akita, however, showed more severe stenosis in the proximal than the distal portion. A high incidence (88.3%) of thrombosis formation corresponding to the site of infarction was observed in AMI in Osaka. Moreover, ruptured atheromatous plaques were identified as being responsible for 62.6% of the coronary thrombosis cases, and a high incidence (70.0%) of foamy cell infiltration was disclosed. Thus, it can be concluded that ruptured atheromatous plaque is a major factor in the progression of coronary atherosclerosis and/or thrombosis, which might be due to the process of plaque softening.

Adult↗
PubMed1987

[A case of malignant histiocytosis with paraplegia].

A 66-year-old man was admitted for shortness of breath and showed fever, abdominal fullness and paraplegia. Monocytosis amounting to 25% and an elevation of serum LDH (4,281 mIu), were remarkable in the laboratory findings. He died of pulmonary insufficiency about a month after admission. On autopsy hepatomegaly (1950 g), splenomegaly (780 g), but no lymphadenopathy and small infarction in the thoracic spinal cord causing paraplegia was noted. Histopathologically, the invasion of the tumor cells into the liver, spleen, lymph nodes, bone marrow and other organs was observed. Malignant histiocytosis was diagnosed by histologic and immunohistochemical studies (lysozyme positive, S-100 protein negative).

Aged↗
PubMed1986

[Studies on fibrinolysis and ascites accumulation associated with peritonitis carcinomatosa--effects of protease inhibitors (PI) on MM2 ascites tumor growth, ascites accumulation and fibrinolysis].

The effects of protease inhibitors(PI), t-AMCHA, gabexate, aprotinin and heparin on the growth of mouse MM2 ascites tumor (MAT) and on several components of fibrinolysis were studied. The drugs were administered intraperitoneally one time daily for 12 days, one day after the tumor transplant. The volumes of ascites, total packed cell volume (TPCV) and fibrinolytic parameters (FDP, whole plasmin, plasminogen activator (PA)) were measured on the 8, 10 and 12th days of therapy. Fibrinolytic activity was assayed by the lysin sepharose affinity chromatography-radio caseinolytic method. Fibrinolytic activity in the ascites increased during the tumor growth. The ascites accumulation as well as levels of FDP, whole plasmin and PA in the drug treated group were significantly decreased when compared to the control group. In these drug-treated groups, MAT cells agglutinated in the abdominal cavity, but in contrast to this, no agglutination was observed in the control group. It was uncertain whether PI directly inhibited tumor growth. The fact that PI inhibited the ascites accumulation and also decreased fibrinolytic activity suggest the involvement of protease in the neoplastic process and indicates another therapeutic approach to malignant ascites tumors.

Animals↗
PubMed1986

[Studies on fibrinolysis and ascites accumulation associated with peritonitis carcinomatosa--inducer of plasminogen activator (IPA) in malignant ascites tumor].

This study was undertaken to investigate the mechanism for hyperfibrinolysis in the ascites associated with peritonitis carcinomatosa. Various combinations of mouse MM2 ascites tumor (MAT) and mouse peritoneum (Mpr) and plasminogen (Plg) were incubated in medium 199 and the fibrinolytic activity of each preparation was assayed. 1) Among the preparations, the preparation of MAT plus Mpr plus Plg showed particularly high fibrinolytic activity. This suggests that plasminogen activator (PA) production is initiated by MAT together with Mpr. 2) Equal volumes of the ultrafiltrate and the concentrate of supernatant from MAT were each separately treated with a Mpr plus Plg preparation and incubated. The fibrinolytic activity of the ultrafiltrate was 10 times as great as that of the concentrate. 3) The ultrafiltrate of MAT was extracted in turn with petroleum ether, ether and hexane. The fibrinolytic activity of the petroleum ether and hexane extracts was higher than that of the ether extracts. These results suggest that MAT has a low polarity, low molecular weight, and lipid like substance (inducer of PA,IPA), which stimulates the Mpr to release PA.

Animals↗
PubMed1985

A lymphoproliferative disorder of T gamma cells with the phenotype of cytotoxic/suppressor T-cell.

A 25-yr-old Japanese male showed unique T gamma cell proliferation different from cases reported previously. His clinical and hematological features were characterized by persistent high fever and the appearance of large lymphocytes with abundant cytoplasm and azurophilic granules in the peripheral blood (11% of the leukocyte differential count) and the ascitic fluid. These lymphocytes showed the ability to bind the Fc portion of IgG and they beared the antigen of cytotoxic/suppressor T-cell defined by monoclonal antibodies. T-cells from this patient suppressed the immunoglobulin production of normal B-cells by pokeweed mitogen, although a polyclonal hypergammaglobulinemia was observed in the serum. Chromosomal abnormality indicated the malignant nature of the proliferating T gamma cells in this patient. The clinical, hematological, and immunological findings characterized the disease of this patient as a distinct entity among the lymphoproliferative disorders of T-cell origin.

Adult↗
PubMed1985

Effect of food ingestion on nifedipine absorption and haemodynamic response.

The absorption of nifedipine (10 mg) and haemodynamic response were studied in 10 patients with myocardial infarction before (Phase A) and after (Phase B) a standardized breakfast. In Phase A, the peak nifedipine concentration (Cmax) and maximum haemodynamic changes were found 1 h after drug administration. In Phase B, the Cmax was lower than that in phase A (43 +/- 6 vs 136 +/- 23 ng/ml, p less than 0.001), and both Cmax and maximum haemodynamic changes were delayed to the fourth hour after administration. Nifedipine plasma concentration correlated significantly with the percent changes in systolic and diastolic blood pressure and heart rate. This study suggests that not only dose but also the time intervals between nifedipine administration and food intake are important in determining the haemodynamic effects.

Blood Pressure↗
PubMed1985

Low-dose cytosine arabinoside regimen induced a complete remission with normal karyotypes in a case with hypoplastic acute myeloid leukaemia with No. 8-trisomy: in vitro and in vivo evidence for normal haematopoietic recovery.

Complete remission was achieved in a case of hypoplastic acute myeloid leukaemia with chromosomal aberration of No. 8-trisomy by giving very low dose of cytosine arabinoside (ara-C), 10 mg (7 X 5 mg/m2)/d, by 24 h continuous intravenous infusion for 20 d. We observed a definite cytoreduction phase in the bone marrow (BM) before normal haematopoiesis resumed. The remission BM showed only normal karyotypes in all metaphases examined. Granulocyte/macrophage colonies and erythroid bursts recovered sufficiently in numbers and cytogenetic study on single colonies and bursts revealed only normal karyotypes. These observations provide evidence that a low dose ara-C regimen can induce remission by cytoreduction which diverts the growth advantage from the leukaemic clone to the normal clones.

Chromosomes, Human, 6-12 and X↗
PubMed1985

Medical management of infective endocarditis; limitations and indication for surgery.

Problems and limitations of medical management for infective endocarditis were studied and surgical indications were discussed based on the retrospective analysis of 55 episodes. Since perioperative complications still occur during highly active infection, antibiotic treatment was suggested as the primary management. Intractable or progressing heart failure appeared to be a definite indication for emergency surgery, but medical therapy was recommended for mild to moderate heart failure. For uncontrolled infection of more than one month duration despite the best available antibiotics, surgical debridement of the infected tissue was indicated. Occurrence of peripheral or fatal emboli was difficult to predict from clinical features and echocardiogram and therefore presented a therapeutic dilemma. Since major or fatal emboli frequently occurred during highly active infection, early initiation of effective antibiotic therapy was considered to be of primary importance. Demonstration of vegetation by echocardiography alone did not seem to justify urgent surgery. In addition, disseminated intravascular coagulation appeared to be a serious complication and thus sedimentation rate should be followed carefully. In the healed stage, prophylactic surgery seemed unnecessary for prevention of recurrent infection or embolization, as they were relatively rare.

Adult↗