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Biomedical subjects

K Fujii

Publications and source records attributed to K Fujii.

At least 415 records · Page 23Linked to original sources
PubMed1996

Renal transplantation in cats with chronic renal failure.

Renal transplantation was performed on 6 cats with chronic renal failure. Clinical signs and the blood chemistry findings (BUN, Cr, IP) improved one week after renal transplantation. Renal anemia also improved 3-4 weeks after surgery. Two cases had the same complications, hydronephrosis and hydroureter within 1 or 2 weeks of surgery, evidenced by marked elevations of BUN and Cr, suggesting that ureteral obstruction at the site of ureterocystostomy is the main complication of renal transplantation in cats. As a new resolution for this problem, we transplanted the ureter with the intact ureteral opening of the bladder from the donor in the remaining 4 cats. Ureteral obstruction was not observed in them, thus the procedure was considered to be useful for avoiding this complication. Two cats died of pneumonia and other complications within 3 months. There were no acute rejections or side effects from the immunosuppressant during the observation period in the remaining four cats.

Animals↗
PubMed1996

Hepatitis B virus carrier status linked to autoimmune hepatitis.

We describe a hepatitis B virus carrier who satisfied the criteria of autoimmune hepatitis proposed by the International Autoimmune Hepatitis Group. A 43-year-old Japanese female showed human leukocyte antigen typing including DR4 in addition to hypergammaglobulinemia, presence of autoantibodies, and liver histology suggestive of autoimmune hepatitis. Moreover, the predominant presence of hepatitis B core antigen in nuclei rather than in cytoplasm of hepatocytes suggested less of a possibility of liver cell damage related to hepatitis B virus infection. She completely responded to immunosuppressive therapy and no clinical or biochemical relapse has been recognized to date.

Adult↗
PubMed1996

Bilateral giant intracavernous carotid artery aneurysms mimicking a cavernous sinus neoplasm--case report.

An 84-year-old female presented with bilateral giant intracavernous carotid artery aneurysms manifesting as right total ophthalmoplegia and trigeminal nerve paresis. Computed tomography and magnetic resonance imaging showed the two aneurysms as one fused mass, so the initial diagnosis was a parasellar tumor occupying the bilateral cavernous sinuses. The correct diagnosis required cerebral angiography. Considering her age, no surgical or interventional treatment was given. Eight months later, her right eye movement partially recovered and she had no further symptoms. There was no definite causative factors other than aging in this case.

Aged↗
PubMed1996

Auditory plasticity in cochlear implant patients.

Dynamic range (DR) of cochlear implant electrodes and speech recognition scores (SRS) were chronologically studied in 23 post-lingually deaf subjects over a period of one year. DR significantly increased over one year (ANOVA, p = 0.03). When DR was compared among three groups of electrodes which were located in the inferior, ascending and superior segments of the cochlear basal turn, that in the superior segment showed the largest increase (p = 0.001), followed by those in the ascending and inferior segments. Vowel and consonant recognition scores with auditory cue were best 6 months after operation and were maintained at the level for one year. Although the time course of improvement differed between DR and SRS, a significant positive correlation was observed at 12 months after operation. Improvement of SRS could be a result of a DR increase in the superior segment of the cochlea, which should convey pitch information over the mid-frequency region.

Adolescent↗
PubMed1996

Identification and antimicrobial activity of urinary metabolites of a rifamycin derivative in dog.

1. Three metabolites of the antimicrobial agent 3'-hydroxy-5'-(4-isobutyl-1-piperazinyl)benzoxazinorifamycin (KRM-1648) were isolated from dog urine obtained after administration of a single oral dose. These metabolites of KRM-1648 were identified by mass spectrometry and 1H and 13C-nmr spectrometry. 2. Three metabolites of KRM-1648 were identified as 25-deacetyl KRM-1648, 30-hydroxy KRM-1648 and 25-deacetyl-30-hydroxy KRM-1648. 3. The antimicrobial activities of 25-deacetyl KRM-1648 were comparable with those of the parent compound, whereas 30-hydroxy KRM-1648 was equipotent and 2-8-fold less active than the parent compound against bacteria and mycobacteria, respectively.

Administration, Oral↗
PubMed1996

In vitro metabolism of a rifamycin derivative by animal and human liver microsomes, whole blood and expressed human CYP3A isoform.

1. In vitro metabolism of a rifamycin derivative, benzoxazinorifamycin KRM-1648, was studied using mouse, rat, guinea pig, dog, monkey and human liver microsomes. 30-Hydroxy-KRM-1648 (M2) was produced in mouse, dog, monkey and human microsomes. 25-Deacetyl-KRM-1648 (M1) was produced in dog and human microsomes, but not in mouse or monkey microsomes. Neither M1 nor M2 was detected in rat or guinea pig microsomes. 2. In dog and human liver microsomes the formation of M2 was dependent on NADPH, but the formation of M1 was not. 3. In vitro metabolism of the parent compound was studied in whole blood in some species. Only M1 was detected in mouse and rat blood, and not in dog and human blood. 4. These findings demonstrated that the metabolite pattern in dog resembled that in man, and suggested that the 30-hydroxylation of KRM-1648 was mediated by cytochrome P450, but that the 25-deacetylation was not. 5. Among the ten recombinant human P450 isoforms used, only the cell lysates including CYP3A3 and CYP3A4 catalysed the M2 formation from KRM-1648.

Animals↗
PubMed1996

Pathology and cellular kinetics of gallbladder with an anomalous junction of the pancreaticobiliary duct.

OBJECTIVES: Anomalous junction of the pancreaticobiliary duct (AJPBD) is thought to be an important risk factor for gallbladder carcinoma in Japan. In this report, we examine histopathology and cellular kinetics of gallbladder mucosae of patients with AJPBD and the possible risk of gallbladder carcinoma. METHODS: We examined 62 gallbladders from patients with AJPBD (group A), 16 gallbladder carcinomas from patients with AJPBD (group B), 60 gallbladder carcinomas from patients without AJPBD (group C), and six normal gallbladders from patients without AJPBD (group D). Histopathology, mucosal heights, and proliferative cell nuclear antigen-labeling index were obtained from routinely processed tissue specimens. RESULTS: The incidence of hyperplastic changes in group A and in the noncancerous regions (NCRs) of group B was greater than in the NCRs of group C (p < 0.05). The incidence of dysplastic changes in the NCRs of group B was greater than in the NCRs of group C (p < 0.05). The mucosal heights in group A and in the NCRs of group B were higher than in the NCRs of group C (p < 0.05). A high proliferative cell nuclear antigen-labeling index was observed in group A and in the NCRs of group B, where hyperplastic changes were frequently observed. CONCLUSIONS: These results suggest that a sequence of hyperplastic changes with a corresponding increase in cellular kinetics with progression through dysplasia to carcinoma may be important in carcinogenesis in gallbladders of patients with AJPBD. AJPBD itself may be a possible risk for gallbladder carcinoma.

Adolescent↗
PubMed1996

[Measurement of the plasma transforming growth factor-beta 1 (TGF-beta 1) level in patients of gastric carcinoma--compared with the serum IAP level and the lymphocyte subsets (CD3, CD4, CD8)].

We evaluated the clinical significance of the plasma TGF-beta 1 by enzyme-linked immunosorbent assay (ELISA) in 40 patients with gastric carcinoma before operation who were hospitalized at our department between August 1992 and March 1993. Moreover, we examined the correlation of the immunosuppressive acidic protein (IAP) in the serum with the plasma TGF-beta 1 level. The lymphocyte subsets were analyzed with monoclonal antibodies (CD3, CD4, CD8) and compared with the plasma TGF-beta 1 level. Results 1) The plasma TGF-beta 1 was significantly high in patients with advanced stage of gastric carcinoma (with respect to the depth invasion) and poorly differentiated adenocarcinoma (histological type) (p < 0.01). When the carcinoma was macroscopically found to be advanced, TGF-beta 1 was higher in the invasive type than in the noninvasive type (p < 0.05). 2) We found a significant correlation between the plasma TGF-beta 1 and IAP in the serum (n = 25, r = 0.677, p < 0.01). 3) The lymphocyte fraction of CD3, CD4 was decreased in patients with a high level of TGF-beta 1, and was related with the plasma TGF-beta 1 level. Thus, TGF-beta 1 was presumed to be deeply associated with in the growth and progression of gastric carcinoma and related to systemic immunosuppressive reaction.

CD3 Complex↗
PubMed1996

[A familial case of Gorlin syndrome].

An 11-year-old girl was admitted to Chiba University Hospital because of the infection of jaw cysts. She had many pits on her palms and soles, basal cell nevus, and typical facial features to Gorlin syndrome (nevoid basal cell carcinoma syndrome). Her 14-year-old sister and 44-year-old father also had similar clinical symptoms, thus they were diagnosed as having a familial Gorlin syndrome. Recently, the father had a complication of maxillary cancer. Colony formation tests after X-ray and ultraviolet irradiation in skin fibroblasts derived from these sisters revealed no remarkable hypersensitivity to these agents. It is important to make an early diagnosis and a proper management in Gorlin syndrome, which has cancer predisposition.

Adolescent↗
PubMed1996

Postoperative evaluation of pylorus-preserving gastrectomy for early gastric cancer.

Physical results after pylorus-preserving gastrectomy (PPG) with preservation of the vagus nerve were evaluated. The status of 15 patients with early gastric cancer after PPG was compared with that of 14 patients after distal gastrectomy (DG). The postoperative/preoperative body-weight ratio of the PPG group (0.99) was significantly greater than that of the DG group (0.92). Patients who had PPG had fewer postoperative abdominal symptoms than those who underwent DG. The gastric emptying pattern of patients who had a pylorus-preserving procedure was slower than that of those who had conventional gastrectomy, and more similar to the preoperative pattern. Contraction of the gallbladder after PPG was better than after DG. Gastroscopy revealed that the mucosa of the stomach remnant after PPG was less abnormal than after DG. In conclusion, PPG is a more physiological operation than conventional DG and should be applied in carefully selected cases of early gastric cancer.

Body Weight↗
PubMed1996

[General anesthesia for expandable endotracheobronchial metal stent insertion].

We experienced eight cases of general anesthesia for endotracheobronchial expandable metal stent insertion. Awake intubation was performed following NLA induction. Anesthesia was maintained by inhalational anesthetics and fentanyl was added under spontaneous breathing assisted manually. Two patients showed a marked hemodynamic change and hypoxia due to endotracheobronchial bleeding and suction. Six patients received EMS insertion with no trouble. We conclude that endotracheobronchial bleeding is an important factor to be watched for during anesthetic management for EMS insertion.

Aged↗
PubMed1996

[Clinical characteristics and therapeutic strategy for acute myocardial infarction in the elderly].

Many randomized studies have revealed that reperfusion therapy is an epochmaking treatment for acute myocardial infarction (AMI). However, it is no clear whether it is equally beneficial in the elderly or not. In this study, we elucidated the clinical characteristics and effectiveness of reperfusion therapy and discussed the optimal treatment for AMI in the elderly. The study population comprised 1,891 consecutive patients with AMI. The reinfarction rates and the rates of Killip class III or IV on admission increased with age. The mortality was significantly higher in the older subgroups. In the patients with first AMI within 24 hours of the onset and who underwent emergency catheterization, those accompanied by hypercholesterolemia or with habitual smoking were significantly fewer in the older group. Although the Q-wave MI rate, the peak CPK level and the reperfusion rate were no different, the low cardiac output condition, multi vessel disease and short-term mortality were significantly greater in the older group. The patients over 80-year-old were subdivided into three groups; those treated conventionally (G-C), those treated with intracoronary thrombolysis (G-T) and those treated with direct PTCA (G-A). The overall mortality did not differ among the three groups. However, in patients hospitalized after 1990, the mortality in G-A was significantly lower than in G-C. The prevalence of bleeding complications between G-A and G-T did not differ. The patients in G-A showed greater improvement of the left ventricular wall motion and lower incidence of postinfarctional angina than other groups. Reperfusion therapy by direct PTCA appears to be the optimal strategy for treatment of elder patients with AMI.

Adult↗
PubMed1996

High frequency of p53 gene mutation in adenocarcinomas of the gallbladder.

p53 mutations in adenocarcinomas of the gallbladder were analyzed by deoxynucleotide sequencing of the gene. Of 23 cases, 16 (70%) harbored 18 missense mutations in exon 5, 6, or 8 of the p53 gene. The characteristics of the p53 mutation spectrum observed in gallbladder carcinomas were (a) frequent mutations at an A:T pair [10 (55%) of 18 mutations], (b) high transversion incidence [12 (66%) of 18 mutations], and (c) only one mutation at the CpG site. The immunohistochemical study revealed that 36 (55%) of 65 cases showed an abnormal accumulation of p53 immunoreactivity, and 12 (52%) of 23 cases had p21 expression. No statistical correlation was observed between p53 and p21 immunoreactivity. These results suggest that p53 mutations may confer the carcinogenesis of the adenocarcinoma of the gallbladder with the specific mutation spectrum of p53.

Adenocarcinoma↗
PubMed1996

[Fatty acid metabolic disorder detected by 123I-BMIPP SPECT shortly after elective percutaneous transluminal coronary angioplasty].

UNLABELLED: Decreased or unchanged BMIPP uptake is often observed in the repeated SPECT imaging soon after successful angioplasty, although coronary flow remarkably recovers. To evaluate clinical significance of this phenomenon, 23 patients underwent BMIPP SPECT before elective PTCA (BM-1), soon after PTCA (72 hours, BM-2), and 3 months later (BM-3). SPECT imagings were divided into 7 segments and were semiquantitatively evaluated by 2 cardiologists in the blinded fashion. Decreased uptake at BM-2 compared with BM-1 was evaluated by comparing with stress Thallium-201 SPECT performed in the same schedule but on the different date (TI-1, 2, 3), ischemic manifestation at PTCA, and wall motion change of LVG. Patients with restenosis were excluded from this study. RESULTS: BM-2 showed decreased uptake in 14 (61%), unchanged in 2 (9%), and increased in 7 (30%) patients, while stress TI showed increased perfusion in all patients. Among 91 myocardial segments correspondent to PTCA vessels, 30 (33%) showed overt uptake reduction, and only 13 (14%) segments showed increased uptake. BM-2 uptake reduction was significantly associated with the absence of collateral artery (odds ratio, OR = 3.1, p <0.01), multi vessel disease (OR = 2.0, p = 0.01), total balloon inflating time (p <0.05), ST elevation on ECG (OR = 3.6, p = 0.01), chest pain during PTCA (OR = 3.1, p <0.1), while pre-dilatation by using small size balloon catheter prevented BM-2 uptake reduction (OR = 6.0, p = 0.01). Multiple logistic regression analysis showed that chest pain, balloon inflating time and pre-dilatation were independently associated with BM-2 uptake reduction. Three months after PTCA. the segments with BM-2 reduction had stress TI uptake similar to the segments without BM-2 reduction, however, they showed poorer recovery of BM-3 uptake and LV wall motion. CONCLUSION: BMIPP uptake reduction shortly after angioplasty was associated with ischemic manifestation and poor LV motion recovery, thus, it may be a sensitive representation of the stunned myocardium.

Aged↗
PubMed1996

[Preoperative diagnosis and surgical treatment for lymph node metastasis in gastric cancer].

In order to clarify the preoperative diagnostic ability for lymph node metastasis, images from magnetic resonance imaging (MRI), computed axial tomography (CT) and ultrasonography (US) were evaluated in 200 gastric cancer patients. The long-term results of 2,000 gastric cancer patients who had undergone gastrectomy were also studied to evaluate the effectiveness of lymphadenectomy. 1) Preoperative diagnosis of lymph node metastasis: The detection rate of lymph nodes around the stomach was 34.1% in MRI, 18.7% in CT and 5.0% in US. The incidence of metastasis was over 80% when the size of lymph node imaged was 1.5 cm and over, against 25% for lymph nodes less than 1.0 cm in size. The detection rate of metastatic lymph node according to the mode of metastasis was 88% for macro-nodular type, 66% for micro-nodular type, 57% for diffuse type in MRI, 70, 41 and 15% in CT, and 38, 3, 0% in US, respectively. Therefore, MRI was most useful for detecting metastatic lymph node preoperatively. 2) Long-term results of gastric cancer with lymph node metastasis: The cumulative 5-year survival rate was 84.2% in n0, 56.1% in n1, 33.7% in n2, 16.5% in n3, and 5.1% in n4 patients. Satisfactory long-term results were obtained for n2 or less patients without serosal invasion. Moreover, by paraaortic lymph node dissection, the cumulative 5-year survival rate in n4 patients was 16.4% (27.8% for cases with radical resection). These results showed the effectiveness of lymph node dissection for gastric cancer.

Follow-Up Studies↗
PubMed1996

Effects of the new calcium antagonist efonidipine hydrochloride on resting and exercise hemodynamics in patients with stable effort angina.

The action of efonidipine hydrochloride ((+/-)-2-[benzyl(phenyl)-amino]ethyl 1,4-dihydro-2,6-dimethyl-5-(5,5-dimethyl-2-oxo-1, 3,2-dioxaphosphorinan-2-yl)-4-(3-nitrophenyl)-3-pyridinecarboxy late hydrochloride ethanol, CAS 1110011-76-8, NZ-105) a new dihydropyridine calcium antagonist, on cardiac hemodynamics at rest and during exercise as well as plasma concentration and pharmacokinetic parameters were studied in 9 patients with angina pectoris. NZ-105 was administered 40 mg once daily for a week and cardiac hemodynamics parameters were measured at rest and during exercise using a bicycle ergometer before and after treatment. All patients showed anginal symptoms during exercise before treatment, while only 4 showed anginal symptoms during exercise after treatment. Improvement on electrocardiograms (ECG) (> 0.1 treatment mV) was detected in 4 out of 9, and NZ-105 was recognized to have an anti-anginal action. The mean plasma concentration of NZ-105 at the time was 14.5 ng/ml. At rest, reduction in blood pressure and decrease in total peripheral vascular resistance were observed, however, NZ-105 showed no effect on heart rate, cardiac index, pulmonary arterial pressure and central venous pressure. During maximum exercise, a decrease in total peripheral vascular resistance, reduction in pulmonary arterial pressure and central venous pressure, increasing tendency of left ventricular ejection fraction, and increase in cardiac index were observed. However, NZ-105 showed no effect on heart rate and blood pressure. Based on the results mentioned above, cardiac hemodynamics of NZ-105 during exercise, featured primarily, reduction of afterload and improvement of cardiac functional deterioration due to exercise. In conclusion, NZ-105 is useful in patients with ischemic cardiac diseases by improving hemodynamics and ECG findings during exercise in patients with effort angina.

Angina Pectoris↗
PubMed1996

[A case of advanced gastric cancer with multiple liver metastasis successfully treated with combination chemotherapy using UFT, CDDP and etoposide].

We reported a 66-year-old male patient with advanced gastric cancer accompanied by multiple liver metastasis, who responded to combination chemotherapy using UFT, CDDP and etoposide. The patient was administered three courses of 600 mg/body UFT po daily, 50 mg/body CDDP iv and 50 mg/body etoposide iv on days 1 and 8 every 4 weeks. As a result, both the primary and metastatic tumors decreased remarkably in size. Adverse reactions were leukocytopenia (Grade 2), thrombocytopenia (Grade 1) and nausea (Grade 1). he is alive 16 months after the beginning of therapy in a condition of partial response (PR). This combination therapy seemed to be effective for advanced gastric cancer.

Adenocarcinoma↗