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Biomedical subjects

K Dan

Publications and source records attributed to K Dan.

At least 109 records · Page 6Linked to original sources
PubMed1996

[Anesthetic management of a patient with tuberous sclerosis].

Tuberous sclerosis is characterized by facial angiofibromatosis, epilepsy, and mental retardation. There have been only a few reports of anesthetic management of patients with tuberous sclerosis. We managed a 22-year-old patient with tuberous sclerosis using nitrous oxide (67%) in oxygen supplemented with fentanyl and midazolam. There were no untoward events related to anesthesia and surgery. Problems in managing patients with tuberous sclerosis are also discussed.

Adult↗
PubMed1996

[Myoglobinuria following anesthesia with enflurane and succinylcholine in an asthmatic child on theophylline].

An 8-year-old asthmatic child on theophylline was anesthetized with enflurane in nitrous oxide and oxygen. He developed a generalized muscle rigidity after intravenous succinylcholine. Although the maximum rectal temperature was 37.9 degrees C, a marked elevation in muscle-derived enzymes and myoglobinuria were observed. The relations among theophylline which is a derivative of xanthines, inhalation anesthetics, and myoglobinuria are discussed.

Anesthesia, Inhalation↗
PubMed1996

[Low-dose chemotherapy].

We examined the clinical results of low-dose chemotherapy in patients with myelodysplastic syndromes (MDS) and refractory acute myelocytic leukemia (AML) who were treated in our institution. Of 34 patients with MDS treated with low-dose cytarabine, 11 achieved complete remission (CR) and six achieved partial remission (PR). The CR rate of patients whose blasts had Auer bodies was significantly higher than that of the patients whose blasts did not. Although the duration of remission was generally short, the overall survival was longer in the responders (CR cases + PR cases) than in the nonresponders. Of 13 patients with MDS treated with low-dose etoposide. one achieved CR and four achieved PR. Of seven patients treated with a combination low-dose therapy consisting of cytarabine and etoposide, two achieved CR. The clinical data in some cases suggested that blasts differentiate into mature myeloid cells in vivo. Low-dose chemotherapy is one therapeutic strategy for MDS and refractory AML. Further studies on the therapy should be conducted to increase the CR rate and to prolong the duration of CR.

Acute Disease↗
PubMed1996

The inhibition of ganglionic transmission via presynaptic dopamine DA1 and postsynaptic DA2 receptor activation in the canine cardiac sympathetic ganglia.

The involvement of dopaminergic mechanisms in modulating ganglionic transmission of the dog cardiac sympathetic ganglia were investigated in both in vivo and in vitro experiments. The positive chronotropic responses to preganglionic stellate stimulation were inhibited by R(+)SK&F38393 and talipexole administered directly to the ganglia through the artery, and the inhibitory effects were antagonized by pretreatment with R(+)SCH23390 and S(-)sulpiride, respectively. McN-A-343 and 1,1-dimethyl-4-phenylpiperazinium iodide given through the artery to reach the ganglia displayed dose-dependent positive chronotropic effects. The positive chronotropic effects were inhibited by (-)quinpirole and talipexole, but not by R(+)SK&F38393. The inhibitions were antagonized by S(-)sulpiride and tended to be antagonized by yohimbine. The acetylcholine output from the isolated stellate ganglia by preganglionic stimulation (5 Hz) was unaffected in the presence of (-)quinpirole and talipexole, but was concentration-dependently reduced in the presence of R(+)SK&F38393, and the reduction was antagonized by R(+)SCH23390. The results thus suggest that the dopamine receptor agonists inhibit the ganglionic transmission by reducting acetylcholine release via preganglionic DA1 receptor stimulation and by inhibiting postganglionic nicotinic and muscarinic activation via postganglionic DA2 receptor stimulation.

(4-(m-Chlorophenylcarbamoyloxy)-2-butynyl)trimethy↗
PubMed1995

Lineage-unrestricted hematologic response to granulocyte colony-stimulating factor in a patient with refractory anemia with excess blasts.

We report a patient with refractory anemia with excess blasts who showed a lineage-unrestricted hematologic response to granulocyte colony-stimulating factor (G-CSF). After 17 months of a stable disease state, the patient developed pneumonia, progression of cytopenia, and reduced cellularity and blast mass in the bone marrow. He was given G-CSF to overcome the pneumonia. Not only the neutrophil count, but also the platelet count increased soon after initiation of the G-CSF therapy; both counts became normal on the fifth day of the G-CSF therapy. Additionally, the anemia improved gradually. The neutrophil and platelet counts were maintained in the normal range for 3 months after cessation of the G-CSF. In vitro studies showed that G-CSF alone stimulated megakaryocyte colony formation from bone marrow mononuclear cells (BMMNC), and accessory cells in the BMMNC were necessary for expression of this G-CSF-induced in vitro megakaryocytopoiesis. These results suggest that, in coordination with accessory cells, G-CSF stimulated megakaryocytopoiesis in the patient. This case provides valuable information for understanding the mechanisms of a lineage-unrestricted hematologic response to G-CSF, which is very rarely observed in MDS.

Anemia, Refractory, with Excess of Blasts↗
PubMed1995

Establishment and characterization of a villous lymphoma cell line from splenic B-cell lymphoma.

A new B-cell line (VL51) with cytoplasmic villi was established from a female patient with splenic lymphoma with circulating villous lymphocytes (SLVL). The patient exhibited a clinical picture characteristic of SLVL, including massive enlargement of the spleen. Tartrate-resistant acid phosphatase (TRAP)-negative villous lymphocytes were seen in the peripheral blood, bone marrow (BM) and both red and white pulps of the spleen. Monoclonality of the VL51 cell line was confirmed by clonal genotype abnormalities in the immunoglobulin heavy chain (IgH) gene and the T-cell receptor beta (TCR beta) gene. Evidence for commitment of phenotype of the VL51 cell line to the B lineage was also shown by the immunophenotype, including expression of CD10, CD19, CD20 and surface immunoglobins. The VL51 cells were positive for Epstein-Barr virus nuclear antigen (EBNA). The VL51 cell line is the first SLVL cell line to be established, and it is expected to be useful in clarifying the leukemogenesis of SLVL.

Acid Phosphatase↗
PubMed1995

Bactericidal activity of skin disinfectants on methicillin-resistant Staphylococcus aureus.

We studied bactericidal activity of 10% povidone-iodine, 0.5% chlorhexidine gluconate, and 0.5% chlorhexidine in 80% ethanol on four strains of methicillin-resistant and two strains of methicillin-susceptible Staphylococcus aureus. The pathogen was exposed to each of the disinfectants for 15, 30, 60, 120, and 240 s at room temperature. The inocula from these suspensions were cultured 72 h at 37 degrees C after the antimicrobial activity of the disinfectants in the suspensions was inactivated by 1:1000 dilution with neutralizer. No organism grew in any of the strains after exposure to 0.5% chlorhexidine in 80% ethanol. The 15-, 30-, and 60-s exposure to 10% povidone-iodine reduced the mean colony count by 55.2%, 91.2%, and 96.7%, respectively, and the exposures to 0.5% chlorhexidine gluconate reduced the mean colony count by 37.2%, 77.1%, and 93.3%, respectively. The difference in colony count between disinfectants was significant at 15- and 30-s exposures (P < 0.01 and 0.05, respectively). The results suggest that bactericidal activity of 0.5% chlorhexidine in 80% ethanol is more potent and more rapid against methicillin-susceptible and methicillin-resistant strains of S. aureus.

Chlorhexidine↗
PubMed1995

Continuous epidural infusion of local anesthetics and shorter duration of acute zoster-associated pain.

OBJECTIVE: The purpose of this study was to investigate the effects of continuous epidural blockade on acute zoster-associated pain, compared with intermittent epidural blocks. DESIGN: The design was a retrospective, nonrandomized study. SETTING: The study was conducted at a university hospital in Japan from 1982 through 1992. PATIENTS: A total of 178 otherwise healthy patients hospitalized with moderate or severe herpes zoster lesions. INTERVENTIONS: Group A (n = 66) had intermittent epidural blocks using 1% mepivacaine, 4-6 ml, three to six time daily; group B (n = 43) were given intermittent epidural blocks and parenteral acyclovir (500 mg/day) or vidarabine (600 mg/day) for 5 days; group C (n = 69) were administered a continuous epidural 0.5% bupivacaine infusion (0.3-1.0 ml/h) for approximately 2 weeks and antiviral agents followed by intermittent blocks. MAIN OUTCOME MEASURES: The number of treatment days was used as the outcome measure. RESULTS: The length of treatment was significantly shorter in group C than in groups A or B. For moderate lesions the means (days) were 36.2 [95% confidence interval (CI), 31.4-41.7), 45.6 (95% CI, 34.0-61.4), and 26.8 (95% CI, 22.3-32.3) for groups A, B, and C, respectively (p < 0.01). For severe lesions they were 73.3 (95% CI, 55.1-97.7), 81.7 (95% CI, 59.1-113.0), and 44.9 (95% CI, 35.2-57.3) for groups A, B, and C, respectively (p < 0.01). CONCLUSIONS: Continuous epidural blockade for patients with acute zoster can shorten the duration of treatment and may reduce the incidence of postherpetic neuralgia.

Anesthesia, Epidural↗
PubMed1995

Effects of interleukin-12 on natural killer cell cytotoxicity and the production of interferon-gamma and tumour necrosis factor-alpha in patients with myelodysplastic syndromes.

The effects of interleukin 12 (IL-12) on natural killer (NK) cell cytotoxicity and on the production of interferon-gamma (IFN-gamma) and tumour necrosis factor-alpha (TNF-alpha) were examined in 15 patients with myelodysplastic syndromes (MDS), which are well known to have immunologic defects, and in 11 normal subjects. The NK cell cytotoxicity of all of the normal subjects was augmented by incubation with IL-12 alone, and co-incubation with interleukin 2 (IL-2) further augmented it (type A response). The MDS patients showed varied responses to IL-12/IL-2. Seven patients showed the type A response, resulting in augmented NK cell cytotoxicity which was similar to that in the normal subjects. In five other patients the cytotoxicity was not increased by IL-12 alone, but the combination of IL-12 and IL-2 did augment the cytotoxicity (type B response). The augmented cytotoxicity in these type B patients was lower than that in the normal subjects. In the final three MDS patients the cytotoxicity was low and not affected by IL-12 and/or IL-2 (type C response). All patients with refractory anaemia with excess blasts (RAEB) and patients with RAEB in transformation showed a type B or C response. Conversely, six of eight refractory anaemia patients showed a type A response. In MDS patients there was a positive correlation between the percentage of CD3- CD56+ cells in pre-incubated cells and the cytotoxicity of cells incubated with IL-12/IL-2. The combination of IL-12 and IL-2 augmented IFN-gamma and TNF-alpha production by nonadherent mononuclear cells in a synergistic or cumulative manner, respectively, in most patients. These results suggest that IL-12, alone or with IL-2, may modulate these important immunologic functions in most MDS patients.

Adult↗
PubMed1995

Effects of D-phenylalanine-derivative hypoglycemic agent A-4166 on pancreatic alpha- and beta-cells: comparative study with glibenclamide.

We have reported that N-[(trans-4-isopropyl-cyclohexyl)-carbonyl]-D-phenylalanine (A-4166) stimulates insulin secretion in animal studies. To further elucidate the mechanisms underlying the actions of this agent, we investigated the effects of A-4166 on insulin and glucagon secretion with or without diazoxide, an ATP-sensitive potassium channel opener, using isolated perfused rat pancreas preparations, and compared the results with those of glibenclamide. Both 30 mumol/l A-4166 and 3 mumol/l glibenclamide significantly stimulated insulin secretion and reduced glucagon secretion to similar levels at a glucose concentration of 5.6 mmol/l (p < 0.01 for both vs. basal levels). After infusion of A-4166 was stopped, insulin levels promptly returned to the basal values, while insulin levels increased further even after discontinuation of glibenclamide. Furthermore, 100 mumol/l diazoxide significantly inhibited the insulin-stimulatory effects of both 30 mumol/l A-4166 and 3 mumol/l glibenclamide (p < 0.05 and p < 0.01, respectively). However, the effects of diazoxide on glucagon secretion differed between the two groups; 30 mumol/l A-4166 produced a transient increase in glucagon secretion (p < 0.05 vs. basal levels) but 3 mumol/l glibenclamide suppressed glucagon secretion further (p < 0.01 vs. without diazoxide) with concomitant administration of 100 mumol/l diazoxide. These findings suggest that A-4166 directly stimulates insulin secretion, at least in part, through mechanisms resembling those of sulfonylurea, but exerts different effect on glucagon secretion in isolated perfused rat pancreas.

Analysis of Variance↗
PubMed1995

Stimulating activity of A-4166 on insulin release in in situ hamster pancreatic perfusion.

Using the in situ hamster pancreatic perfusion system, the stimulating action of A-4166 on insulin release was examined in comparison with that of glibenclamide. Both antidiabetic agents stimulated insulin release, but its onset by A-4166 was faster than that by glibenclamide. In the presence of a basal glucose concentration (3 mmol/l), insulin releases induced by A-4166 and glibenclamide were inhibited by preexisting diazoxide. At higher glucose concentrations (5-16.7 mmol/l), however, A-4166 was able to reverse the inhibitory effect of diazoxide on the first and second phases of insulin release, while glibenclamide did not reverse the first-phase release. On the other hand, in the presence of 16.7 mmol/l of glucose A-4166 completely reversed the inhibitory action of diazoxide added simultaneously, but glibenclamide reversed it only partially. In the presence of 8 mmol/l of glucose, the stimulating action of A-4166 and glibenclamide on insulin release was hardly affected by inhibitors of ATP production. These results indicate that the stimulating action of A-4166 on insulin release is different from glibenclamide in response to the inhibitory action of diazoxide. These results also suggest that A-4166 is an effective agent for release of insulin by acting on the KATP channel, especially under an impaired function of pancreatic B cells.

Animals↗
PubMed1995

Effects of interleukin-1 and tumor necrosis factor on megakaryocytopoiesis: mechanism of reactive thrombocytosis.

We studied the effects of interleukin-1 (IL-1) and tumor necrosis factor (TNF) on mouse megakaryocytopoiesis to evaluate the role of these cytokines in reactive thrombocytosis associated with inflammation. Injections of IL-1 or TNF to mice induced a significant increase in the megakaryocyte progenitor cell (CFU-Meg) count in the spleen. When IL-1 and TNF were injected simultaneously, the splenic CFU-Meg count was remarkably increased compared with mice injected with either IL-1 (p < 0.003) or TNF (p < 0.001) alone. On the other hand, neither IL-1 nor TNF showed any megakaryocyte-potentiating or -stimulating effects in vitro. In the sera obtained 4 h after administration of IL-1, TNF or both, high megakaryocyte potentiating activities were found. Furthermore, an extremely high level of IL-6 was detected in the serum after administration of both IL-1 and TNF. These results strongly suggest that IL-1 and TNF stimulate megakaryocytopoiesis indirectly via other cytokine(s) induced from accessory cells, and that increased levels of IL-1 and TNF play important roles in the development of reactive thrombocytosis caused by inflammation.

Animals↗
PubMed1995

Characterization of insulin-dependent diabetes mellitus induced by a new variant (DK-27) of encephalomyocarditis virus in DBA/2 mice.

A murine diabetes mellitus induced with a new diabetogenic variant (DK-27) which we isolated from the M variant of the encephalomyocarditis (EMC) virus was characterized. Male DBA/2 mice (9.5 weeks old) were infected with various infectious doses of DK-27 intraperitoneally. Blood glucose and insulin levels were examined in association with the viral replication. Pancreatic pathology and hormone contents and stable hemoglobin A1c (St-A1c) levels were also examined on the final day of observation (35 days of post-infection). In infected mice, blood glucose levels rapidly elevated at 72 hr, slightly decreased between 7 and 10 days and finally became sustained hyperglycemia. On the other hand, blood insulin levels elevated at 48 hr, promptly decreased, and subsequently became sustained hypoinsulinemia. Viral replication in pancreases reached the highest titers at 48 hr and rapidly disappeared with all infectious doses used. Pancreatic insulin contents in infected mice were not detectable, and glucagon contents were not affected. In pathological examination, atrophy of islets and marked diminution of B-cells were observed, and A-cells occupied the major part of an infected islet. St-A1c levels reflected lasting hyperglycemia. These findings show that DK-27 causes insulin-dependent diabetes mellitus by the specific and direct destruction of pancreatic B-cells in susceptible mice. Such a diabetic model mouse will be useful for therapeutic studies.

Animals↗
PubMed1995

Dual rearrangement of immunoglobulin and T-cell receptor genes in a case of splenic lymphoma with villous lymphocytes.

We report here a case of "splenic lymphoma with villous lymphocytes" (SLVL) which exhibited both B- and T-cell phenotypes and genotypes. The patient was a 73-year-old man. Physical examination revealed splenomegaly and lymphadenopathy. The white blood cell count was 55.2 x 10(9)/L with 70.5% atypical lymphocytes, having cytoplasmic villi, characteristic of SLVL. The atypical cells infiltrated both the red and white pulps. Immunological analysis of the peripheral leukocytes showed both B- and T-cell phenotypes (CD5,CD11c,CD19,CD20,HLA-DR, SmIgM and lambda positive). DNA analysis revealed a dual rearrangement of the immunoglobulin heavy chain gene and T-cell receptor beta gene. SLVL has been identified as a B-cell leukemia with a relatively benign clinical course. This case had both B- and T-cell pheno- and genotypes with a progressive course. To the best of our knowledge, no case of SLVL with dual genotypes has ever been reported.

Aged↗
PubMed1995

Trimetaphan may cause coronary artery spasm.

We describe a patient in whom possible coronary artery spasm occurred during the infusion of trimetaphan. A 55-year-old man with a meningioma was scheduled for surgical excision of the tumour. He denied any previous history of chest pain. Anaesthesia was maintained with nitrous oxide (67%) in oxygen. The blood pressure before commencement of the surgery was 114/70 mmHg, and the pulse rate was 60 beats min-1. The blood pressure rose to 152/94 mmHg (the pulse rate to 62 beats min-1) during incision of the scalp, and intravenous infusion of trimetaphan was initiated. The blood pressure gradually decreased to 113/58 mmHg (the pulse rate 64 beats min-1) 10 min after start of this infusion, and premature ventricular contractions were evident on the electrocardiogram. Trimetaphan was withheld, and lignocaine was given intravenously. The premature ventricular contractions disappeared but ST segments were elevated. Glyceryl trinitrate was then infused intravenously. The ST segments remained elevated for 5 min, were depressed for 2 min and finally became isoelectric. There were no wide swings in blood pressure or pulse rate during the event. Post-operative laboratory examination revealed no evidence of myocardial infarction. Recovery of the patient was uneventful.

Adjuvants, Anesthesia↗
PubMed1994

Elevated plasma soluble interleukin 2 receptor level correlates with defective natural killer and CD8+ T-cells in myelodysplastic syndromes.

The plasma soluble interleukin 2 receptor (sIL-2R) level and its relationships with haematologic and immunologic data were examined in 40 patients with myelodysplastic syndromes (MDS). The plasma sIL-2R level was significantly higher in the high-risk MDS group (refractory anaemia with excess blasts (RAEB), RAEB in transformation and chronic myelomonocytic leukaemia) than in the low-risk MDS group (refractory anaemia (RA) and RA with ringed sideroblasts) or in normal subjects, although there was considerable variation in the plasma sIL-2R level within each MDS group. The plasma sIL-2R level correlated positively with the bone marrow cellularity and bone marrow blast mass, but not with the absolute number of CD25+ lymphocytes. This may support the idea that plasma sIL-2R is derived from malignant MDS cells in the bone marrow. The plasma sIL-2R level correlated negatively with the absolute numbers of the CD8+, CD3-CD16+, and CD3-CD56+ cell populations in freshly isolated lymphocytes, the percentage of CD3-CD56+ cells in lymphokine (interleukin 2)-activated killer (LAK) cells, and the cytotoxicity of LAK cells. We conclude that MDS patients having a high plasma sIL-2R level often have a defect in natural killer and CD8+ T-cells.

Adult↗