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Biomedical subjects

K Cho

Publications and source records attributed to K Cho.

At least 289 records · Page 16Linked to original sources

Gastrointestinal/pancreatic hormone concentrations in the portal venous system of nine patients with organic hyperinsulinism.

Percutaneous transhepatic sampling of blood in the portal venous system (TPVS) was used to; (1) localize hormone secreting tumors and help in differentiating tumors from diffuse disease (nesideoblastosis and hyperplasia with adenomata) in 9 patients with fasting hypoglycemia and hyperinsulinism, and (2) study the concentration an distribution of the immunoreactive peptides: insulin (IRI), gastrin (IG), glucagon (IRG), pancreatic polypeptide (hPP), and somatostatin (SRIF-LI), in the venous drainage of the uninvolved portion of the pancreas and GI tract. Localized elevations of IRI (64-920 microunits/ml) predicted tumor localization in 6 patients with single tumors that were not demonstrable angiographically. In one patient with nesideoblastosis and another with islet cell hyperplasia with adenoma, elevated IRI concentrations at multiple locations suggested a diffuse or multicentric process. Elevations of SRIF-LI in the same region as IRI elevations in one patient and of IRG in another patient suggested that these tumor produced two hormones. Some problems in the interpretation of portal venous insulin concentrations are discussed. The locations of maximum portal venous system plasma concentrations and portal-arterial gradients (mean +/- SE pg/ml) in five patients with small single insulinomas were: IG, gastrocolic trunk (126 +/- 27, 46 +/- 22); IRG, proximal splenic vein (130 +/- 30, 47 +/- 13) and gastrocolic trunk (131 +/- 23, 60 +/- 13); hPP, portal vein (164 +/- 48, 49 +/- 22); SRIF-LI, superior mesenteric vein (186 +/- 50, 57 +/- 20) and gastrocolic trunk (178 +/- 59, 55 +/- 21). It is concluded; (1) TPVS can be used successfully to localize single insulin-secreting tumors of the pancreas and to help distinguish them from diffuse disease but problems in such differentiation do occur, (2) circulating SRIF-LI and IRG are derived from both the pancreas and the gut, IG predominantly from the proximal gut and hPP from the head of the pancreas, and (3) The data provide new information for the interpretation of portal insulin concentrations in patients with organic hyperinsulinism and of hormone concentrations for localization of peptide-producing tumors of the pancreas other than insulinomas.

Adenoma↗

[Clinical results of cefadroxil in children and pharmacokinetics of the drug (author's transl)].

Cefadroxil was administered orally at a daily dose of 30-40 mg/kg to 8 cases of the infection of upper respiratory tract mainly due to beta-hemolytic Streptococcus, and efficacy was obtained in 7 cases, this rate being considered to be satisfactory, though the cases were too few to reach a conclusion. As to pathogens of bacterial infection of upper respiratory tract, beta-hemolytic Streptococcus and Staphylococcus aureus were encountered especially frequently, and in view of antibacterial activity against these 2 bacteria, our results could be approved. Further investigations should be performed carefully, however, to determine if cefadroxil may be a drug of first choice in the treatment of severe bacterial pneumonia and pyothorax. No side effects were observed throughout our treatment, though digestive tract disorders, especially diarrhea, are most frequent in literatures. As to pharmacokinetical characteristic of cefadroxil, almost the same results were obtained to other reports, though our data are insufficient as our experience was limited in only 1 case. Serum levels were determined after 35.7 mg/kg of cefadroxil were administered once orally, and a peak of about 38 mcg/ml appeared 2 hours later, and a high level of about 30 mcg/ml was maintained at 5 hours, though an oral dose was high. Efficacy for large area of bacterial infections may be expected from these serum levels. From urine collected simultaneously, about 74% of cefadroxil was recovered within more than 4 hours. This showed that cefadroxil was well absorbed from digestive tract, and a major part was excreted rapidly through kidney. From the results of our experiment, characteristics of cefadroxil may be summarized as follows. Cefadroxil is absorbed well after oral administration, antibacterial action is fully expected from serum level, a major part is excreted through kidney, and clearance is good. Cefadroxil will be recommended especially for bacterial infections of upper respiratory tract due to beta-hemolytic Streptococcus and Staphylococcus aureus.

Cefadroxil↗

Evaluation of cholangeographic procedures in diagnosis of obstructive jaundice.

Endoscopic retrograde cholangiography, percutaneous transhepatic cholangiography with external bile drainage and a combined method utilizing both procedures were evaluated in 187 patients with obstructive jaundice. Ductal obstructive regions were located in 90 per cent of cases by endoscopic retrograde cholangiography, and 55 per cent of these were correctly diagnosed. Complications were observed in 7.9 per cent with a mortality rate of 2.9 per cent. The most serious complication was cholangitic sepsis. By percutaneous transhepatic cholangiography with external bile drainage, ductal obstructive regions were correctly located in 82 per cent, 37 per cent of these patients were correctly diagnosed. Complications occurred in 9.2 per cent with a mortality rate of 1.5 per cent. The most serious complication was massive bleeding. Successful external bile drainage could be obtained in most cases. The combined method overcomes the disadvantages of the single methods and the cause of obstructive jaundice can be diagnosed more precisely. The surgeon has a better knowledge of the type and the extent of the lesion prior to definitive surgery and can operate more safely on patients with obstructive jaundiced when the serum total bilirubin, has decreased to a level below 5 mg/dl.

Adult↗

Major pulmonary artery stenosis causing pulmonary hypertension in sarcoidosis.

A chest bruit and evidence of pulmonary hypertension developed in a woman with sarcoidosis. A perfusion lung scan revealed decreased perfusion to the right upper lobe and to the entire left lung, while a ventilation scan was normal. Pulmonary angiography demonstrated multiple bilateral concentric pulmonary artery stenoses most consistent with extrinsic compression by mediastinal granulomatous inflammation and fibrosis. The patient was treated with systemic corticosteroids for one year without improvement. Major pulmonary artery stenosis should be considered in patients with sarcoidosis who developed pulmonary hypertension and are found to have lung scans showing segmental perfusion defects in normally ventilated areas or who develop an unexplained chest bruit.

Adult↗

Pancreatography with contrast medium containing polyethylene hydrogenated castor oil.

A new contrast medium has been used for endoscopic pancreatography. Good visualization of the pancreas was obtained by this method. No side-effects of this method were observed by clinical and histologic examination, either in clinical or experimental studies. Clinically, the new method provided more detailed information regarding pancreatic changes in chronic pancreatitis. It is suggested that this method may make detection of a small tumor of the pancreas in the parenchyma and permit earlier diagnosis of carcinoma of the pancreas.

Amylases↗

[Pharmacokinetics and results of clinical administration of CS-1170. I. Pharmacokinetics of CS-1170 (author's transl)].

(1) When 20.8 approximately 34.7 mg/kg body weight of CS-1170 were instilled intravenously for 30 minutes to one hour, peak levels were obtained on completion of the intravenous drip in the range 85.7 approximately 1,117.3 microgram/ml. (2) The half life was 22 approximately 49 minutes which is very rapid. (3) The kidney clearance was 6.8 approximately 104.8 ml/min. (4) The total clearance was 5.9 approximately 111.5 ml/min, showing correlation with the kidney clearance. (5) The apparent distributional capacity was 0.3 approximately 4.3 liters, showing a strong correlation with body weight.

Bacterial Infections↗

[Pharmacokinetics and results of clinical administration of CS-1170. II. Results of clinical administration of CS-1170 (author's transl)].

The intravenous preparation of CS-1170 was administered in 9 cases of pediatric disease and was excellent or good in 5 cases (55.6%). It was poor in 3 of 4 cases of Mycoplasma pneumonia. We think that the dose of 50 mg/kg/day can exert an effect regardless of the intensity of symptoms. Through our present experiences with the excellent or good cases, an intravenous drip or intratracheal injection for 3 approximately 5 days is effective. Although there was no abnormality in the biochemistry or electrolyte findings before or after administration, eruption developed in one of the cases in which the drug was administered for 6 days.

Age Factors↗

Basic experiments on oral administration of 5-fluorouracil emulsion as adjuvant chemotherapy to surgical treatment for gastric cancer.

Oral administration of 5-fluorouracil (5-FU) emulsion was compared experimentally with that of 5-FU aqueous solution as to the degree of absorption and tissue distribution. After oral administration of both the 5-FU emulsion and the 5-FU solution, 5-FU was detected at the highest level in both the stomach and the duodenum. This seems to suggest that 5-FU is strongly affinitive to the tissues of the gastrointestinal tract. As to the relative concentration of these two forms of the drug, the oral administration of the 5-FU emulsion resulted in a maximum value 1.5 times higher than that of the 5-FU solution. An appreciable concentration of 5-FU was maintained for a considerably long time with the administration of 5-FU emulsion. In the lymph, the maximum level of the 5-FU emulsion was three times higher than that of the 5-FU solution. The drug concentration of the 5-FU emulsion remained higher than that of the 5-FU solution through the entire duration of the experiment. Regarding the drug concentration in the regional lymph nodes, the pattern demonstrated was almost the same as in the lymph itself. It is expected that the oral administration of 5-FU emulsion may be useful as an adjuvant to the surgical treatment of gastric cancer, because of the high drug concentration resulting both in the gastrointestinal tract and in the regional lymph nodes.

Administration, Oral↗

Histological evaluation of the effect of 5-FU emulsion on lymph node metastasis of stomach cancer.

In order to evaluate the effect of anticancer drugs on the metastatic lesions of the regional lymph nodes from stomach cancers removed after oral administration of 5-FU emulsion, histological examinations of the specimens obtained from 107 surgical cases were carried out. In additional 13 cases with gastric cancer, the active 5-FU concentrations in the regional lymph nodes were determined. The effect of 5-FU emulsion in metastatic lesions as determined was histologically classified into Grades 0 to III according to the severity and extent of damaged cells and cell nests Grades II and III were judged to demonstrate the beneficial effect of the 5-FU emulsion. Such changes were identified in 62.0 per cent of the 242 metastatic lymph nodes, and the effectiveness increased as the total dose of the 5-FU emulsion administered increased (50.9 per cent for 5,000 mg or less, 70.9 per cent for 5,000 to 6,000 mg, and 72.7 per cent for 6,000 mg or more). The rate of effectiveness also varied with the histological type of the primary carcinoma, i.e. the differentiated type being more sensitive. The mean active 5-FU level in the regional lymph nodes was higher after the administration of 5-FU emulsion than of 5-FU solution supporting the earlier animal experiments.

Adenocarcinoma↗

Effects of neonatal hypoxia on brainstem cholinergic neurons-pedunculopontine nucleus and laterodorsal tegmental nucleus.

Hypoxic changes in the cholinergic neurons of the pedunculopontine nucleus (PPN) and the laterodorsal tegmental nucleus (LDT) were studied morphologically using immunohistochemistry for choline acetyltransferase (ChAT). Fifty-three postnatal day (PND) 7 Sprague-Dawley rats were subjected to a hypoxic load of 8% oxygen for 5 h. The rats which survived were later sacrificed at PND 14 or 28 for histological analysis. The results were compared with those obtained from control rats. Three weeks after hypoxic load, a decrease in the number of ChAT immunoreactive cells, especially in the caudal PPN, was found, although no remarkable changes were detected in cell morphology. Since several studies support the possibility that the cholinergic system from PPN/LDT is responsible for both REM generation and the general motor inhibition during REM sleep, our results may account, in part, for the clinical features of hypoxic brain damage such as sleep disorders and abnormal muscle tonus.

Animals↗

Muscle histopathology in spastic cerebral palsy.

We studied the histopathology of spastic muscles in patients with spastic cerebral palsy using specimens obtained from the gastrocnemius muscles during orthopedic operations. Though there was no disease-specific abnormality, we found changes in fiber type distribution, i.e., type-1 fiber predominance and type-2B fiber deficiency. These changes were not found in the patient with brain infarction at age 1 year 5 months. Variation in fiber size, especially in type-1 fibers, was also detected in older patients and at the more severely affected sides. We speculated that the influence on the spinal motor unit from upper motor cortex might be applicable to the muscle histological findings and the time of the onset of the brain damage might be important.

Adenosine Triphosphatases↗

Hirschsprung disease, unusual face, mental retardation, epilepsy, and congenital heart disease: Goldberg-Shprintzen syndrome.

A 5-year-old girl with Hirschsprung disease, unusual facial appearance, psychomotor retardation, epilepsy, and congenital heart disease is reported. Patients with similar clinical features have been reported and they appear to exhibit the recently identified Goldberg-Shprintzen syndrome. It is believed that this girl also exhibits this new syndrome. Cranial computed tomography demonstrated abnormal findings that may suggest defective neuronal migration and/or dysgenesis of the brain. These findings were considered to cause psychomotor retardation and epilepsy in this patient.

Child, Preschool↗